Individual
DR. CARENA MAY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
111 BEAVER GRADE ROAD, LAPWAI, ID 83540-0367
(208) 843-2842
(309) 527-3525
Mailing address
P.O. DRAWER 367, NIMIIPUU HEALTH, 111 BEAVER GRADE ROAD, LAPWAI, ID 83540-0367
(208) 843-2842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036123865
IL
207Q00000X
Family Medicine Physician
Primary
336.086682
IL
207Q00000X
Family Medicine Physician
3676
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336086682
ILLINOIS CONTROLLED SUBSTANCE #
IL
Enumeration date
05/31/2006
Last updated
11/22/2011
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