Provider Demographics
NPI:1780807339
Name:THOMPSON, MARGARET WADDINGTON (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:WADDINGTON
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 KIEFER BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3818
Mailing Address - Country:US
Mailing Address - Phone:916-875-5015
Mailing Address - Fax:916-875-5734
Practice Address - Street 1:9601 KIEFER BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3818
Practice Address - Country:US
Practice Address - Phone:916-875-5015
Practice Address - Fax:916-875-5734
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP6262363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP6262OtherNP LICENSE