Provider Demographics
NPI:1881635365
Name:THOMPSON, MALEE S (NP)
Entity Type:Individual
Prefix:
First Name:MALEE
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 344054
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29634-0001
Mailing Address - Country:US
Mailing Address - Phone:864-656-2233
Mailing Address - Fax:
Practice Address - Street 1:735 MCMILLAN RD.
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-4054
Practice Address - Country:US
Practice Address - Phone:864-656-2233
Practice Address - Fax:864-656-0760
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCUPIN657029373OtherGRP UPIN P657029373 BEH EFFECTIVE 10/08/2010
SCUPIN 65702Medicare UPIN