Provider Demographics
NPI:1316991185
Name:THOMPSON, DENISE WALKER (NP)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:WALKER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 DEER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-9553
Mailing Address - Country:US
Mailing Address - Phone:864-223-2425
Mailing Address - Fax:
Practice Address - Street 1:102 ROCKCREEK BLVD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-8915
Practice Address - Country:US
Practice Address - Phone:864-725-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 242363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0958Medicaid
SCQ62305Medicare UPIN
SCAA12211124Medicare PIN