Individual
TINA M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
607 WOLVERINE DRIVE, KOTZEBUE, AK 99752-1073
(907) 442-7903
(907) 442-7932
Mailing address
PO BOX 1073, KOTZEBUE, AK 99752-1073
(907) 442-7903
(907) 442-7932
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM3780
—
AK
Enumeration date
05/09/2007
Last updated
07/09/2007
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