Provider Demographics
NPI:1295854586
Name:THOMPSON, KIRSTEN L (LIC AC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CARTERS LN
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-5206
Mailing Address - Country:US
Mailing Address - Phone:540-564-9819
Mailing Address - Fax:
Practice Address - Street 1:225 N HIGH ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-3826
Practice Address - Country:US
Practice Address - Phone:540-564-9819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219798171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist