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Individual

BAILEY NICOLE THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
169 MAPLEWOOD DR, LOUISA, KY 41230-5730
(606) 585-3747
Mailing address
169 MAPLEWOOD DR, LOUISA, KY 41230-5730
(606) 585-3747

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5792
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8060PA
SC
Enumeration date
01/22/2024
Last updated
06/10/2025
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