Provider Demographics
NPI:1033714381
Name:THOMPSON, LINDA J
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 MARYVILLE LN
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2524
Mailing Address - Country:US
Mailing Address - Phone:937-418-0758
Mailing Address - Fax:
Practice Address - Street 1:210 MARYVILLE LN
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2524
Practice Address - Country:US
Practice Address - Phone:937-418-0758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide