Individual
STEPHANIE MARIE GONSHOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2347 S HIGHWAY 17, MURRELLS INLET, SC 29576-7611
(843) 357-2443
(843) 357-2132
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 652-8226
(843) 652-8032
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22336
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22336
SC STATE LICENSE
SC
Enumeration date
12/18/2018
Last updated
03/16/2021
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