Individual
MS. JEANNE PATRICIA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1714 HIGHWAY 17 S, NORTH MYRTLE BEACH, SC 29582-4041
(843) 361-0705
(843) 361-4045
Mailing address
1600 HIGHWAY 17 N, SURFSIDE BEACH, SC 29575-6015
(843) 238-4520
(843) 361-4045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TL1299
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL1299
PA
SC
Enumeration date
05/14/2007
Last updated
03/13/2008
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