Provider Demographics
NPI:1972103273
Name:THOMPSON, CHRISTINE A
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3693 BIA ROAD 10
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-3822
Mailing Address - Country:US
Mailing Address - Phone:701-244-2117
Mailing Address - Fax:
Practice Address - Street 1:3693 BIA ROAD 10
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-3822
Practice Address - Country:US
Practice Address - Phone:701-244-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant