Provider Demographics
NPI:1609971829
Name:THOMPSON, KRISTIN DAWKINS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:DAWKINS
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:DAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 N EAGLE CREEK DR
Mailing Address - Street 2:STE 360
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1827
Mailing Address - Country:US
Mailing Address - Phone:859-258-5270
Mailing Address - Fax:859-258-5202
Practice Address - Street 1:120 N EAGLE CREEK DR
Practice Address - Street 2:SUITE 360
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1827
Practice Address - Country:US
Practice Address - Phone:859-258-5270
Practice Address - Fax:859-258-5202
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004218363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY37903705OtherMEDICIAD LAB GROUP
KY78011384Medicaid
KYCB5773OtherRR MEDICARE GROUP
P00246492OtherRR MEDICARE PIN
KY4000501OtherMEDICARE LAB GROUP
P00246492OtherRR MEDICARE PIN
KY78011384Medicaid
KY0169Medicare PIN