Individual
TARA M THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4824 E BASELINE RD STE 140, MESA, AZ 85206-4680
(480) 969-4040
(480) 830-1042
Mailing address
19713 E CHERRY HILLS PL, QUEEN CREEK, AZ 85142-6272
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
AP10708
AZ
363LF0000X
Family Nurse Practitioner
AP10708
AZ
Other
Enumeration date
07/25/2017
Last updated
02/07/2020
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