Provider Demographics
NPI:1346784386
Name:JUNIPER WOMEN'S HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:JUNIPER WOMEN'S HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM, APRN
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, APRN
Authorized Official - Phone:864-344-2783
Mailing Address - Street 1:1225 MONTAGUE AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-9027
Mailing Address - Country:US
Mailing Address - Phone:864-519-0054
Mailing Address - Fax:864-447-5707
Practice Address - Street 1:1225 MONTAGUE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-9027
Practice Address - Country:US
Practice Address - Phone:864-519-0054
Practice Address - Fax:864-447-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346784386OtherBUSINESS NPI
1942631254OtherNPI
1548845944OtherNPI