Healthcare Provider Details
I. General information
NPI: 1295768083
Provider Name (Legal Business Name): GINA THOMPSON FINGERLIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
140 IVORY KEY RD SALUDA SCHOOL DISTRICT
SALUDA SC
29138
US
IV. Provider business mailing address
1179 BATESBURG HWY
SALUDA SC
29138-8485
US
V. Phone/Fax
- Phone: 864-445-3011
- Fax:
- Phone: 864-445-2976
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 35656 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | APN 995 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: