Individual
JENNIFER ELLEN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4525 SW 13TH ST, GAINESVILLE, FL 32608-3901
(352) 377-8619
(352) 371-9674
Mailing address
4525 SW 13TH ST, GAINESVILLE, FL 32608-3901
(352) 377-8619
(352) 371-9674
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102686
FL
363AM0700X
Medical Physician Assistant
PA9102686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009862200
—
FL
Enumeration date
05/22/2006
Last updated
01/18/2022
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