Provider Demographics
NPI:1437138419
Name:THOMPSON, CYNTHIA COCKRELL (ACNP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:COCKRELL
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 HULON LN
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4841
Mailing Address - Country:US
Mailing Address - Phone:803-256-0464
Mailing Address - Fax:803-254-5121
Practice Address - Street 1:1333 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2953
Practice Address - Country:US
Practice Address - Phone:803-256-0464
Practice Address - Fax:803-254-5121
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2035207RP1001X
SC2035363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner