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Individual
MICHELLE L THOMPSON
Active
Individual
MICHELLE L THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1034
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233508
MIDLANDS CHOICE
NE
01
—
39327
BCBS
NE
01
—
994
STATE LICENSE
NV
Enumeration date
07/24/2006
Last updated
03/11/2013
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