Provider Demographics
NPI:1619216496
Name:THOMPSON, SARA ANN (APN)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 TIMBERWOLF TRL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4965
Mailing Address - Country:US
Mailing Address - Phone:501-231-0404
Mailing Address - Fax:501-255-6000
Practice Address - Street 1:10100 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6202
Practice Address - Country:US
Practice Address - Phone:501-255-6000
Practice Address - Fax:501-255-6405
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARATP-000532363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care