Individual
LESLIE J THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
421 CHESTNUT ST, EVANSVILLE, IN 47713-1227
(812) 426-9855
(812) 858-4536
Mailing address
PO BOX 3868, EVANSVILLE, IN 47737-3868
(812) 426-9855
(812) 858-4536
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001284A
IN
363LF0000X
Family Nurse Practitioner
71001284A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000281995
ANTHEM
IN
05
—
200365440
—
IN
01
—
78007234
KY MEDICAID
KY
Enumeration date
12/04/2006
Last updated
01/09/2013
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