Provider Demographics
NPI:1912914185
Name:THOMPSON, SARA V (MSN, CRNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:V
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-BC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:V
Other - Last Name:TEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125
Mailing Address - Country:US
Mailing Address - Phone:205-814-9284
Mailing Address - Fax:205-338-0865
Practice Address - Street 1:70 PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125
Practice Address - Country:US
Practice Address - Phone:205-814-9284
Practice Address - Fax:205-338-0865
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-097727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ40557Medicare UPIN