Provider Demographics
NPI:1063045912
Name:TOMPKINS, DELTA DURANT (RN)
Entity Type:Individual
Prefix:
First Name:DELTA
Middle Name:DURANT
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DELTA
Other - Middle Name:DAWN
Other - Last Name:DURANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2143 TANGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-7246
Mailing Address - Country:US
Mailing Address - Phone:803-968-6140
Mailing Address - Fax:
Practice Address - Street 1:2143 TANGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-7246
Practice Address - Country:US
Practice Address - Phone:803-968-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC222792163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health