Provider Demographics
NPI:1457142978
Name:THOMPSON, JASMINE GREATHOUSE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:GREATHOUSE
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 1:10 EXECUTIVE PARK DRIVE NORTHEAST
Mailing Address - Street 2:APT 542
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329
Mailing Address - Country:US
Mailing Address - Phone:720-833-1885
Mailing Address - Fax:
Practice Address - Street 1:60 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1115
Practice Address - Country:US
Practice Address - Phone:321-843-5851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant