Provider Demographics
NPI:1770050023
Name:THOMPSON, CIERRA (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247372
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-7372
Mailing Address - Country:US
Mailing Address - Phone:614-598-4495
Mailing Address - Fax:
Practice Address - Street 1:5599 WESTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9365
Practice Address - Country:US
Practice Address - Phone:614-598-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home