Provider Demographics
NPI:1740738707
Name:THOMPSON'S FAMILY PSYCHIATRIC CARE, PLLC
Entity Type:Organization
Organization Name:THOMPSON'S FAMILY PSYCHIATRIC CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:704-864-8775
Mailing Address - Street 1:1006 UNION RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0466
Mailing Address - Country:US
Mailing Address - Phone:704-864-8775
Mailing Address - Fax:
Practice Address - Street 1:1006 UNION RD
Practice Address - Street 2:SUITE B
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0466
Practice Address - Country:US
Practice Address - Phone:704-864-8775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC180906363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty