Provider Demographics
NPI:1225330376
Name:THOMPSON, KATHRYNN SUE (MS, RN, PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYNN
Middle Name:SUE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, RN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WEST 10TH AVENUE
Mailing Address - Street 2:M200 STARLING-LOVING HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210
Mailing Address - Country:US
Mailing Address - Phone:614-293-3237
Mailing Address - Fax:614-293-6037
Practice Address - Street 1:320 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1280
Practice Address - Country:US
Practice Address - Phone:614-293-3237
Practice Address - Fax:614-293-6037
Is Sole Proprietor?:No
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 138887 NS-01815163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult