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General NPI Number Information
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NPI Number | 1053834705
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Entity Type | Individual
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Provider Name | ANGELA AMICK THOMAS FNP-C, AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 171 MONROE LN
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City | LEXINGTON
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State | SC
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Zip | 29072-3904
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Country | US
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Telephone | 803-358-8496
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Fax | 866-614-3887
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Provider Business Mailing Address
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Address Line | 21614 SC HIGHWAY 121
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City | WHITMIRE
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State | SC
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Zip | 29178-9410
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Country | US
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Telephone | 803-917-2496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 21171
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21171
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License Number State | SC
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