Individual
DERHONDA MAE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
312 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-9559
Mailing address
312 W HIGH ST, LEBANON, KY 40033-1428
(270) 692-9559
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008853
KY
Other
Enumeration date
08/12/2014
Last updated
11/25/2014
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