Provider Demographics
NPI:1316555659
Name:THOMPSON, CHRYSTAL LANDRY (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:LANDRY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:CHRYSTAL
Other - Middle Name:LANDRY
Other - Last Name:KIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5811 MARTHAS DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-6001
Mailing Address - Country:US
Mailing Address - Phone:318-446-7348
Mailing Address - Fax:
Practice Address - Street 1:44 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3960
Practice Address - Country:US
Practice Address - Phone:866-679-7067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN061843163W00000X
LA214585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse