Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Healthsource Medical Clinic PC

Organization Family Nurse Practitioner · NPI 1619271103

Healthsource Medical Clinic PC is a Family Nurse Practitioner 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
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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