Individual
JESSIE PERNELL GOETHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
1680 RIBAUT RD, PORT ROYAL, SC 29935-2008
(843) 522-7190
(843) 379-9686
Mailing address
1680 RIBAUT RD, PORT ROYAL, SC 29935-2008
(843) 522-7193
(843) 379-9686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21756
SC
Other
Enumeration date
04/04/2018
Last updated
09/26/2024
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