Provider Demographics
NPI:1922377613
Name:THOMPSON, DONNA LYNETTE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNETTE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROOKLYN CIR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2613
Mailing Address - Country:US
Mailing Address - Phone:931-684-5056
Mailing Address - Fax:
Practice Address - Street 1:2762 HIGHWAY 231 N
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7315
Practice Address - Country:US
Practice Address - Phone:931-680-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-24
Last Update Date:2011-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily