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Individual

TINA TERREL THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C, RN

Contact information

Practice address
2130 ACADEMY CIR STE D, COLORADO SPRINGS, CO 80909-1675
(719) 425-2631
Mailing address
PO BOX 50542, COLORADO SPRINGS, CO 80949-0542
(719) 210-3207

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0994623-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14473158
CAQH
Enumeration date
09/12/2019
Last updated
09/12/2019
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