Healthcare Provider Details

I. General information

NPI: 1316991185
Provider Name (Legal Business Name): DENISE WALKER THOMPSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ROCKCREEK BLVD
GREENWOOD SC
29649-8915
US

IV. Provider business mailing address

224 DEER CREEK RD
GREENWOOD SC
29649-9553
US

V. Phone/Fax

Practice location:
  • Phone: 864-725-5020
  • Fax:
Mailing address:
  • Phone: 864-223-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSC 242
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: