Provider Demographics
NPI:1760973358
Name:THOMPSON, KAREN-FAYE DENISE (NP-C)
Entity Type:Individual
Prefix:
First Name:KAREN-FAYE
Middle Name:DENISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6721 THOMASVILLE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4876
Mailing Address - Country:US
Mailing Address - Phone:850-431-9000
Mailing Address - Fax:
Practice Address - Street 1:6721 THOMASVILLE RD STE 4
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-4875
Practice Address - Country:US
Practice Address - Phone:850-431-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186802163W00000X, 363L00000X
FLRN9441574163W00000X
FLARNP9441574363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse