Provider Demographics
NPI:1508141284
Name:THOMPSON, FAITH JEAN
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:JEAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 E KLONDIKE TRL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4344
Mailing Address - Country:US
Mailing Address - Phone:605-759-4682
Mailing Address - Fax:
Practice Address - Street 1:2805 E KLONDIKE TRL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4344
Practice Address - Country:US
Practice Address - Phone:605-759-4682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1024-5752-ST372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion