Individual
JANINE GIBSON SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2000 HAMPTON STREET, COLUMBIA, SC 29223
(803) 785-6626
(803) 602-2069
Mailing address
1016 BUTTERCUP CIRCLE, BLYTHEWOOD, SC 29016
(803) 785-6626
(803) 602-2069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
104109
SC
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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