Provider Demographics
NPI:1265779821
Name:THOMPSON, TAWNY CORAL
Entity type:Individual
Prefix:
First Name:TAWNY
Middle Name:CORAL
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 1:416 N PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4738
Mailing Address - Country:US
Mailing Address - Phone:727-742-4701
Mailing Address - Fax:
Practice Address - Street 1:416 N PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4738
Practice Address - Country:US
Practice Address - Phone:727-742-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula