Provider Demographics
NPI:1366631889
Name:THOMPSON, RICHARD P JR (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:LOWER BRULE
Mailing Address - State:SD
Mailing Address - Zip Code:57548-0248
Mailing Address - Country:US
Mailing Address - Phone:605-473-5526
Mailing Address - Fax:
Practice Address - Street 1:601 GALL ST.
Practice Address - Street 2:
Practice Address - City:LOWER BRULE
Practice Address - State:SD
Practice Address - Zip Code:57548-0248
Practice Address - Country:US
Practice Address - Phone:605-473-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR028977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse