Individual
MS. KASSY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN273957
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT07422041
STATE CONTROLLED SUBSTANCE
MA
01
—
RN273957
STATE LICENSE NUMBER
MA
Enumeration date
12/05/2008
Last updated
05/01/2024
Update your record
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