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Organization
ANGELIC PRIMARY MEDICINE OF SC, LLC
Active
Organization
ANGELIC PRIMARY MEDICINE OF SC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET GIBSON APN (OWNER)
(609) 464-1135
Entity
Organization
Contact information
Practice address
4728 JENN DR STE 102, MYRTLE BEACH, SC 29577-5714
(609) 464-1135
(609) 822-7980
Mailing address
8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
(609) 822-7979
(609) 822-7980
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24726
LICENSE
SC
Enumeration date
07/23/2021
Last updated
06/26/2025
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