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Individual
ROSEANNE K THOMPSON
Active
Individual
ROSEANNE K THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R048823
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N46663
ST CONTROLLED SUBSTANCE
MD
01
—
R048823
STATE LICENSE
MD
Enumeration date
03/07/2007
Last updated
10/14/2020
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