Provider Demographics
NPI:1700892924
Name:THOMPSON, PAMELA JANE (MSNFNP-BC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JANE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSNFNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 WALLACE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8003
Mailing Address - Country:US
Mailing Address - Phone:615-223-6200
Mailing Address - Fax:615-223-6100
Practice Address - Street 1:210 WESTWOOD PL STE 110
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7554
Practice Address - Country:US
Practice Address - Phone:615-206-2462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000093854163W00000X, 163W00000X
261QR1100X, 261QR1100X
TNAPN0000006736363L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518270115OtherGROUP NPI NUMBER
TN3499953Medicaid