Provider Demographics
NPI:1093714933
Name:THOMPSON, SCOTT E (FNP)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:E
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6934 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4620 J C NICHOLS PKWY
Practice Address - Street 2:SUITE 405
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1617
Practice Address - Country:US
Practice Address - Phone:816-960-3000
Practice Address - Fax:816-461-6586
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO132788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06A317Medicare ID - Type Unspecified