Individual
MELODY ELAINE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
853 N CHURCH ST STE 620, SPARTANBURG, SC 29303-3070
(864) 573-7511
(864) 560-1690
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
219744
SC
363LF0000X
Family Nurse Practitioner
Primary
21222
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4651
—
SC
01
—
SCB1965206
MEDICARE PIN
SC
01
—
SCB1966067
MEDICARE PIN
SC
01
—
SCB1966121
MEDICARE PIN
SC
Enumeration date
07/28/2017
Last updated
10/12/2017
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