Individual
KEITRA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
64 BLACK ROCK AVE, BRIDGEPORT, CT 06605-1200
(203) 579-5000
Mailing address
90 KNOB HILL DR, HAMDEN, CT 06518-2428
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8742
CT
363LF0000X
Family Nurse Practitioner
APRNCNP021660
OH
363LF0000X
Family Nurse Practitioner
R214567
MD
363LF0000X
Family Nurse Practitioner
RN1050784
DC
Other
Enumeration date
06/15/2017
Last updated
05/10/2020
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