Provider Demographics
NPI:1639326457
Name:THOMPSON, SHERESSE CHANTE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:SHERESSE
Middle Name:CHANTE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:SHERESSE
Other - Middle Name:CHANTE
Other - Last Name:HARGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3314 ANTLER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-1534
Mailing Address - Country:US
Mailing Address - Phone:910-436-2288
Mailing Address - Fax:
Practice Address - Street 1:2300 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3856
Practice Address - Country:US
Practice Address - Phone:910-488-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC226557163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse