Healthcare Provider Details

I. General information

NPI: 1609747708
Provider Name (Legal Business Name): KATE THOMPSON RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 DOWNING ST
CHARLESTON SC
29407-3917
US

IV. Provider business mailing address

1554 DOWNING ST
CHARLESTON SC
29407-3917
US

V. Phone/Fax

Practice location:
  • Phone: 862-781-0761
  • Fax:
Mailing address:
  • Phone: 863-781-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number232668
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: