Individual
LEILANI BLACKWELL THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
149 TWIN LAKE RD, GAFFNEY, SC 29341-2538
(864) 206-2000
Mailing address
141 TWIN LAKE RD, GAFFNEY, SC 29341-2526
(864) 206-2000
(864) 902-3628
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
61617
SC
163WS0200X
School Registered Nurse
Primary
68617
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68617
—
SC
Enumeration date
08/30/2019
Last updated
08/30/2019
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