Provider Demographics
NPI:1417595455
Name:THOMAS, CATHERINE KING (APRN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KING
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PEAK
Mailing Address - State:SC
Mailing Address - Zip Code:29122-1100
Mailing Address - Country:US
Mailing Address - Phone:803-945-7475
Mailing Address - Fax:803-945-0000
Practice Address - Street 1:32 RIVER ST
Practice Address - Street 2:
Practice Address - City:PEAK
Practice Address - State:SC
Practice Address - Zip Code:29122-1100
Practice Address - Country:US
Practice Address - Phone:803-945-7475
Practice Address - Fax:803-945-0000
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC23536OtherAPRN