Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Healthsource Medical Clinic PC

Organization Family Nurse Practitioner · NPI 1619271103

Healthsource Medical Clinic PC provides Family Nurse Practitioner services in Valdosta, Georgia. Licensed in Georgia. Registered with an NPI since 2010.

Licensed in
GA
In the registry since
2010
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1609 Norman Dr Ste A-1
Valdosta, GA 31601-3753 Not confirmed with CMS for 10 years — call before visiting
Phone: (229) 245-1004
Fax: (229) 245-1074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN130256 (GA)

Record details

NPI number1619271103
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cristi Godwin — President · (229) 245-1004
NPI enumeratedDecember 27, 2010
Last updated in NPPESJanuary 13, 2016
Mailing address1609 Norman Dr, Ste A-1, Valdosta, GA 31601-3753

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