Individual
KELSIE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26305
SC
363LF0000X
Family Nurse Practitioner
26305
SC
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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