Individual
LAURA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1828 W PLAZA DR, WINCHESTER, VA 22601-6365
(540) 662-9115
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-008665
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063147833
—
VA
01
—
VAG858F103
MEDICARE PTAN
VA
Enumeration date
07/17/2022
Last updated
10/31/2023
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