1295768083 NPI number — GINA THOMPSON FINGERLIN APRN

Table of content: GINA THOMPSON FINGERLIN APRN (NPI 1295768083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295768083 NPI number — GINA THOMPSON FINGERLIN APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINGERLIN
Provider First Name:
GINA
Provider Middle Name:
THOMPSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295768083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1179 BATESBURG HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALUDA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29138-8485
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-445-2976
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 IVORY KEY RD
Provider Second Line Business Practice Location Address:
SALUDA SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
SALUDA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-445-3011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  35656 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LW0102X , with the licence number: APN 995 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)