Provider Demographics
NPI:1942631254
Name:GOFF, JANET (MSN, CNM)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:GOFF
Suffix:
Gender:F
Credentials:MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18606367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942631254OtherNPI
SCNW0221Medicaid