Provider Demographics
NPI:1598919805
Name:THOMPSON, CAROL M (RN)
Entity Type:Individual
Prefix:MR
First Name:CAROL
Middle Name:M
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 1:2 MURRAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1122
Mailing Address - Country:US
Mailing Address - Phone:585-243-7290
Mailing Address - Fax:585-243-7297
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1122
Practice Address - Country:US
Practice Address - Phone:585-243-7290
Practice Address - Fax:585-243-7287
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285580163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY285580OtherRN LICENSE