Individual
MRS. KEISHA WYTOKA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
154 BLOUNTVILLE BYP, BLOUNTVILLE, TN 37617-4575
(423) 279-2777
Mailing address
154 BLOUNTVILLE BYP, BLOUNTVILLE, TN 37617-4575
(423) 279-2777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000223875
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3170197
—
TN
Enumeration date
03/26/2019
Last updated
03/26/2019
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