Healthcare Provider Details

I. General information

NPI: 1114836301
Provider Name (Legal Business Name): OLIVIA MARIE LIGHTHART THOMPSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE
CHARLESTON SC
29425-0100
US

IV. Provider business mailing address

799 WOODWARD RD
CHARLESTON SC
29407-7185
US

V. Phone/Fax

Practice location:
  • Phone: 843-412-5812
  • Fax:
Mailing address:
  • Phone: 843-412-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number282897
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: