Provider Demographics
NPI:1457934549
Name:THOMPSON, KASSIDY SHEREE (CLD (DV))
Entity Type:Individual
Prefix:
First Name:KASSIDY
Middle Name:SHEREE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CLD (DV)
Other - Prefix:
Other - First Name:SAGE
Other - Middle Name:ABIGAIL
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CLD (DV)
Mailing Address - Street 1:2100 GRAYSON DR APT 1912
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7017
Mailing Address - Country:US
Mailing Address - Phone:940-783-3402
Mailing Address - Fax:
Practice Address - Street 1:2100 GRAYSON DR APT 1912
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7017
Practice Address - Country:US
Practice Address - Phone:940-783-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula