Provider Demographics
NPI:1992544167
Name:THOMPSON, HAYDEN REECE (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:REECE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:HAYDEN
Other - Middle Name:REECE
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:422 MONTAGUE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-1961
Mailing Address - Country:US
Mailing Address - Phone:864-990-5074
Mailing Address - Fax:
Practice Address - Street 1:422 MONTAGUE AVE STE 5
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1961
Practice Address - Country:US
Practice Address - Phone:864-990-5074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28758363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC28758OtherSC LLR