Provider Demographics
NPI:1407482953
Name:DAY, NIA THOMPSON (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:NIA
Middle Name:THOMPSON
Last Name:DAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASU DR # 779
Mailing Address - Street 2:
Mailing Address - City:LORMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39096-7510
Mailing Address - Country:US
Mailing Address - Phone:601-877-6460
Mailing Address - Fax:601-877-2340
Practice Address - Street 1:1000 ASU DR # 779
Practice Address - Street 2:
Practice Address - City:LORMAN
Practice Address - State:MS
Practice Address - Zip Code:39096-7510
Practice Address - Country:US
Practice Address - Phone:601-877-6460
Practice Address - Fax:601-877-2340
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903498363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool