Provider Demographics
NPI:1265256606
Name:THOMPSON, KRISTOPHER MARTIN (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:MARTIN
Last Name:THOMPSON
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 COBLE DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-8602
Mailing Address - Country:US
Mailing Address - Phone:407-697-4853
Mailing Address - Fax:
Practice Address - Street 1:1941 COBLE DR
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-8602
Practice Address - Country:US
Practice Address - Phone:407-697-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38424363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health