Individual
KACIE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
901 4TH AVE E, SARTELL, MN 56377-4590
(320) 269-1868
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
823195
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
07/20/2022
Last updated
07/20/2022
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