Provider Demographics
NPI:1295921591
Name:THOMPKINS, KATHY J (APRN)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:J
Last Name:THOMPKINS
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 1:1002 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-3920
Mailing Address - Country:US
Mailing Address - Phone:843-464-8205
Mailing Address - Fax:843-464-8206
Practice Address - Street 1:1002 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-3920
Practice Address - Country:US
Practice Address - Phone:843-464-8205
Practice Address - Fax:843-464-8206
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA3334Medicare UPIN