Provider Demographics
NPI:1891133294
Name:THOMPSON, KRISHAWNA MUND (NP-C)
Entity Type:Individual
Prefix:
First Name:KRISHAWNA
Middle Name:MUND
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KRISHAWNA
Other - Middle Name:MARIE
Other - Last Name:MUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 N LIBERTY
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:TX
Mailing Address - Zip Code:77371-2460
Mailing Address - Country:US
Mailing Address - Phone:936-628-1694
Mailing Address - Fax:936-628-3109
Practice Address - Street 1:16 N LIBERTY
Practice Address - Street 2:
Practice Address - City:SHEPHERD
Practice Address - State:TX
Practice Address - Zip Code:77371-2460
Practice Address - Country:US
Practice Address - Phone:936-628-1694
Practice Address - Fax:936-628-3109
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX734317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily