Individual
KAYLA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
(701) 364-8078
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R33462
ND
363LF0000X
Family Nurse Practitioner
Primary
R33462
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1460902
—
ND
Enumeration date
06/27/2014
Last updated
12/26/2015
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