Individual
MS. TERESA LYNN HATHCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1526 LAKE MURRAY BLVD, COLUMBIA, SC 29212-8622
(803) 749-1155
(803) 749-1786
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1731
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89995
RN LICENSE
SC
Enumeration date
05/18/2007
Last updated
02/06/2023
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