Provider Demographics
NPI:1831710284
Name:THOMPSON, ALEXIA VERUSCHKA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:VERUSCHKA
Last Name:THOMPSON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:360 HUNTINGTON AVE
Mailing Address - Street 2:NORTHEASTERN UNIVERSITY 202 ROBINSON HALL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:127 S 500 E STE 620
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1972
Practice Address - Country:US
Practice Address - Phone:571-422-5548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2024-07-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant