Provider Demographics
NPI:1578843330
Name:THOMPSON, NANCY JO (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JO
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N TRAVIS ST STE B2
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5900
Mailing Address - Country:US
Mailing Address - Phone:903-361-5066
Mailing Address - Fax:
Practice Address - Street 1:315 N TRAVIS ST STE B2
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5900
Practice Address - Country:US
Practice Address - Phone:903-361-5066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX580930363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health