Provider Demographics
NPI:1972771251
Name:THOMPSON, PATSY ANN (APN)
Entity Type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 JANIE STREET
Mailing Address - Street 2:
Mailing Address - City:CROWDER
Mailing Address - State:MS
Mailing Address - Zip Code:38622
Mailing Address - Country:US
Mailing Address - Phone:662-326-8839
Mailing Address - Fax:870-295-4795
Practice Address - Street 1:350 GETWELL ST
Practice Address - Street 2:
Practice Address - City:MARKS
Practice Address - State:MS
Practice Address - Zip Code:38646-9785
Practice Address - Country:US
Practice Address - Phone:662-326-8031
Practice Address - Fax:662-326-8560
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR861750363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health