Provider Demographics
NPI:1508021577
Name:THOMPSON, TOMMIE CHADRENA (RN)
Entity Type:Individual
Prefix:MS
First Name:TOMMIE
Middle Name:CHADRENA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 PITTMAN RD
Mailing Address - Street 2:
Mailing Address - City:WHITWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37397-5806
Mailing Address - Country:US
Mailing Address - Phone:615-504-0526
Mailing Address - Fax:
Practice Address - Street 1:504 MCCALLIE AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402
Practice Address - Country:US
Practice Address - Phone:423-634-5890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000129422163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health