Provider Demographics
NPI:1033559125
Name:THOMPSON, STEPHANIE M (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 S HWY 59
Mailing Address - Street 2:BLDG E SUITE 301
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-4948
Mailing Address - Country:US
Mailing Address - Phone:620-820-5850
Mailing Address - Fax:
Practice Address - Street 1:1902 S HWY 59
Practice Address - Street 2:BLDG E SUITE 301
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4948
Practice Address - Country:US
Practice Address - Phone:620-820-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS147081363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health