Provider Demographics
NPI:1942987656
Name:THOMPSON, REEGYN A (APRN)
Entity Type:Individual
Prefix:
First Name:REEGYN
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:REEGYN
Other - Middle Name:A
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:NE
Mailing Address - Zip Code:68719-0052
Mailing Address - Country:US
Mailing Address - Phone:402-630-6065
Mailing Address - Fax:
Practice Address - Street 1:401 S FIFTH ST
Practice Address - Street 2:
Practice Address - City:LYNCH
Practice Address - State:NE
Practice Address - Zip Code:68746-3013
Practice Address - Country:US
Practice Address - Phone:402-569-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily