Provider Demographics
NPI:1730202805
Name:THOMPSON, CYNTHIA MCINTYRE (RN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MCINTYRE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANNE
Other - Last Name:MCINTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4833 LANDRUM DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206
Mailing Address - Country:US
Mailing Address - Phone:803-782-9208
Mailing Address - Fax:803-782-9806
Practice Address - Street 1:1409 DEVINE STREET
Practice Address - Street 2:UNIVERSITY OF SC THOMASON STUDENT HEALTH CENTER
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29208
Practice Address - Country:US
Practice Address - Phone:803-777-3658
Practice Address - Fax:803-777-0126
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21595163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse