Individual
THERESA FAITH ECONOMOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 242-4683
(864) 240-5028
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6306
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
201404814NP-PP
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
3125
SC
363LA2200X
Adult Health Nurse Practitioner
F301965
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201403477 RN
RN
OR
01
—
201404814NP-PP
ADULT NURSE PRACTITIONER
OR
01
—
3125RX
ADVANCED PRACTICE RN
SC
05
—
NP1489
—
SC
Enumeration date
03/05/2007
Last updated
03/07/2023
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