Provider Demographics
NPI:1265407613
Name:THOMSON, LINDA MR (CPNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MR
Last Name:THOMSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 THOMSON DR
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149
Mailing Address - Country:US
Mailing Address - Phone:802-558-9055
Mailing Address - Fax:
Practice Address - Street 1:131 THOMSON DR
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149
Practice Address - Country:US
Practice Address - Phone:802-558-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0019806363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTONP1500Medicaid
S69441Medicare UPIN
VTNP150003Medicare Oscar/Certification