| Doctor Name: | TARA RAE THOMPSON |
| NPI Number: | 1710226204 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | AP 07195 |
| Business Practice Address: | 1012 Louisa St Rayville, LA - 712692957 |
| Business Phone Number: | 3187282046 |
| Business Fax Number: | 3187286163 |
| Mailing Address: | 212 Ashley Ave, RAYVILLE |
| State: | LA |
| Postal Code: | 712693409 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/04/2013 |
| NPI Last Update Date: | 10/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | AP 07195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |