MEDICARE: CAROLINA GAYMON APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	23146	SC

General Provider Information

NPI Number	:	1588202758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA GAYMON APRN

Provider Business Mailing Address
First Line	:	101 WILLIAM H JOHNSON ST STE 300
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29506-2772
Country	:	US
Telephone Number	:	843-777-7863
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 WILLIAM H JOHNSON ST STE 300
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29506-2772
Country	:	US
Telephone Number	:	843-777-7863
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	03/09/2026

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Directions to “ CAROLINA GAYMON APRN” Practice Location

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