Provider Demographics
NPI:1356951693
Name:THOMPSON, CASEY JEAN MORNINGSTAR (NP-C, RN-BC)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:JEAN MORNINGSTAR
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP-C, RN-BC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:JEAN
Other - Last Name:MORNINGSTAR THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16625 NW 203RD ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-0458
Mailing Address - Country:US
Mailing Address - Phone:772-519-1745
Mailing Address - Fax:
Practice Address - Street 1:808 N PARROTT AVE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-2103
Practice Address - Country:US
Practice Address - Phone:888-570-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9297709163W00000X
FLAPRN11010909363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9297709OtherNURSING LICENSE
FLAPRN11010909OtherADVANCED PRACTICE REGISTERED NURSE