Doctor Name: | MRS. KELLEY PRIVETT THOMPSON |
NPI Number: | 1306211156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MSN, AGNP-C |
License Number: | APN.0992043-NP |
Business Practice Address: | 810 W Columbia St Oberlin, KS - 677492450 |
Business Phone Number: | 7854752208 |
Business Fax Number: | 7854752453 |
Mailing Address: | Po Box 268, OBERLIN |
State: | KS |
Postal Code: | 677490268 |
Phone Number: | 7854752208 |
Fax Number: | 7854752453 |
NPI Enumeration Date: | 12/04/2015 |
NPI Last Update Date: | 12/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | APN.0992043-NP |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |