Provider Demographics
NPI:1760790034
Name:THOMPSON, GINGER LYNN (APN)
Entity Type:Individual
Prefix:MS
First Name:GINGER
Middle Name:LYNN
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 1:8350 US HIGHWAY 64 STE 103
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4135
Mailing Address - Country:US
Mailing Address - Phone:901-730-6003
Mailing Address - Fax:
Practice Address - Street 1:8350 US HIGHWAY 64 STE 103
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4135
Practice Address - Country:US
Practice Address - Phone:901-730-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006026363LF0000X
TN14007363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1528954Medicaid
TN1031501827OtherMEDICARE PTAN