Individual
COLETTE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
247 UNION POINT ST, LEXINGTON, GA 30648-2303
(706) 743-8171
(706) 743-3000
Mailing address
PO BOX 459, COLBERT, GA 30628-0459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R607355
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235388463A
—
GA
05
—
393908547A
—
GA
Enumeration date
01/11/2006
Last updated
01/12/2010
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