Individual
GRETTA LAVONNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LINCENSED VOCATIONAL
Contact information
Practice address
4450 W CENTURY BLVD, INGLEWOOD, CA 90304-1504
(310) 671-9247
Mailing address
1234 E 43RD ST, LOS ANGELES, CA 90011-3228
(323) 561-5899
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN188467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VN188467
—
CA
Enumeration date
07/02/2019
Last updated
07/02/2019
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