Provider Demographics
NPI:1265093470
Name:MCLEOD, CASEY GOODEN (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:GOODEN
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:LEIGH
Other - Last Name:GOODEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:604 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-3212
Mailing Address - Country:US
Mailing Address - Phone:843-332-6645
Mailing Address - Fax:
Practice Address - Street 1:604 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-3212
Practice Address - Country:US
Practice Address - Phone:843-332-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily