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Individual

ELLEN THOMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3004855
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
3004855
KY
363LA2200X
Adult Health Nurse Practitioner
71004448A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000501923
ANTHEM BCBS
05
7100022840
KY
Enumeration date
05/01/2006
Last updated
07/24/2018
Update your record

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