Individual
MRS. KIMBERLY THOMAS GAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
700 21ST AVE N, MYRTLE BEACH, SC 29577-7400
(843) 409-5287
Mailing address
2203 WOODLAWN DR, CONWAY, SC 29526-7707
(843) 409-5287
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
39545
SC
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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