Organization
ANGELIC PRIMARY MEDICINE OF SC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET GIBSON APN (OWNER)
(609) 464-1135
Entity
Organization
Contact information
Practice address
4728 JENN DR STE 102, MYRTLE BEACH, SC 29577-5714
(609) 464-1135
(609) 822-7980
Mailing address
8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
(609) 822-7979
(609) 822-7980
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24726
LICENSE
SC
Enumeration date
07/23/2021
Last updated
06/26/2025
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