Provider Demographics
NPI:1962258244
Name:THOMPSON, ANGELIA PICKETT (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANGELIA
Middle Name:PICKETT
Last Name:THOMPSON
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9194
Mailing Address - Country:US
Mailing Address - Phone:803-372-8569
Mailing Address - Fax:
Practice Address - Street 1:1003 W MEETING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2205
Practice Address - Country:US
Practice Address - Phone:803-372-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29040363LF0000X
SC64839163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse