Doctor Name: | MINDY DAWN THOMPSON |
NPI Number: | 1538540745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 19479 |
Business Practice Address: | 133 N Howard Ave Landrum, SC - 293561507 |
Business Phone Number: | 8644573838 |
Business Fax Number: | 8644574159 |
Mailing Address: | Po Box 743070, ATLANTA |
State: | GA |
Postal Code: | 303743070 |
Phone Number: | 8645604304 |
Fax Number: | 8645604413 |
NPI Enumeration Date: | 06/12/2015 |
NPI Last Update Date: | 08/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 19479 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |