Provider Demographics
NPI:1649613035
Name:THOMPSON, KIMBERLY (PMHNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 THUNDERBIRD DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3418
Mailing Address - Country:US
Mailing Address - Phone:214-520-7575
Mailing Address - Fax:214-520-7579
Practice Address - Street 1:3710 RAWLINS ST STE 1370
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4291
Practice Address - Country:US
Practice Address - Phone:214-520-7575
Practice Address - Fax:214-520-7579
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718539363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health