Individual
EVAN MICHAEL THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
4069 CHEROKEE ST NW STE 400, KENNESAW, GA 30144-1278
(470) 766-1193
Mailing address
4655 SHALLOWFORD RD, ROSWELL, GA 30075-3127
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN295468
GA
Other
Enumeration date
03/13/2024
Last updated
07/22/2024
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