Provider Demographics
NPI:1508873597
Name:THOMPSON, AZILEE C (NP)
Entity Type:Individual
Prefix:MRS
First Name:AZILEE
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1790 COLBERT HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-5205
Mailing Address - Country:US
Mailing Address - Phone:931-270-9729
Mailing Address - Fax:931-270-9926
Practice Address - Street 1:529 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3219
Practice Address - Country:US
Practice Address - Phone:931-270-2729
Practice Address - Fax:931-270-9926
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011849363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner