Individual
JACQUELINE JONES THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5306 NC HIGHWAY 55 STE 105, DURHAM, NC 27713-7812
(919) 457-1517
(919) 363-7697
Mailing address
131 BELLFARE DR, GARNER, NC 27529-7366
(919) 418-1246
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5012379
NC
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
5012379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5012379
PSYCHIATRIC NURSE PRACTITIONER
NC
Enumeration date
10/07/2019
Last updated
05/04/2021
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