| Doctor Name: | MRS. TESSA VALENE THOMPSON |
| NPI Number: | 1245385053 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 9295002 |
| Business Practice Address: | 412 Mazley Dr Locust Grove, GA - 302487027 |
| Business Phone Number: | 6787634648 |
| Business Fax Number: | |
| Mailing Address: | 120 Watergate Cv, FAYETTEVILLE |
| State: | GA |
| Postal Code: | 302157501 |
| Phone Number: | 6787634648 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 9295002 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |