Individual
EVAN THURSTON THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
7901 MICHENER AVE, PHILADELPHIA, PA 19150-1320
(484) 250-2226
Mailing address
7901 MICHENER AVE, PHILADELPHIA, PA 19150-1320
(484) 250-2226
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024068522
PA
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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