Provider Demographics
NPI:1891714218
Name:THOMPSON, JANIS P (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:DR
Other - First Name:SANTHA
Other - Middle Name:
Other - Last Name:KURIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:RR 1 BOX 296
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-9738
Mailing Address - Country:US
Mailing Address - Phone:814-224-2551
Mailing Address - Fax:814-940-7749
Practice Address - Street 1:2907 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4305
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:814-940-7749
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000629C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health