Provider Demographics
NPI:1821115478
Name:THOMPSON-MCKINNEY, KATHRYN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:THOMPSON-MCKINNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 S 111TH DR # 400
Mailing Address - Street 2:
Mailing Address - City:CASHION
Mailing Address - State:AZ
Mailing Address - Zip Code:85329-9800
Mailing Address - Country:US
Mailing Address - Phone:480-359-7509
Mailing Address - Fax:480-336-1991
Practice Address - Street 1:12374 W HOPI ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-3127
Practice Address - Country:US
Practice Address - Phone:480-414-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP036337164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse