Individual
RONELLE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
11 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-4300
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
18685
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3215
—
SC
Enumeration date
03/05/2014
Last updated
04/13/2021
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