Provider Demographics
NPI:1912893652
Name:THOMPSON, KATHERINE PIERCE (RD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PIERCE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 SANTA ADRIANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7498
Mailing Address - Country:US
Mailing Address - Phone:615-438-5799
Mailing Address - Fax:
Practice Address - Street 1:3708 SANTA ADRIANA AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-7498
Practice Address - Country:US
Practice Address - Phone:615-438-5799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
086088528133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered