Individual
JUANETTA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
325 MEDINA CT, KISSIMMEE, FL 34758-4302
(407) 552-7679
Mailing address
325 MEDINA CT, KISSIMMEE, FL 34758-4302
(407) 552-7679
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP 2141902
FL
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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