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Individual
MRS. SARA NICOLE THOMPSON
Active
Individual
MRS. SARA NICOLE 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
PA9108278
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KQ667
FL MEDICARE
FL
01
—
MEDICARE
MEDICARE
FL
01
—
PA9108278
LICENSE
FL
05
—
PENDING
—
FL
Enumeration date
02/08/2011
Last updated
07/20/2022
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