Individual
SUSAN F THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
ONE MEDICAL VILLAGE DRIVE, INDEPENDENT ANESTHESIOLOGISTS PSC, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867
Mailing address
PO BOX 12749, COVINGTON, KY 41012-0749
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1072153
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
020396
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000228158
ANTHEM BLUE SHIELD
—
05
—
2384610
—
OH
05
—
74203969
—
KY
Enumeration date
02/28/2006
Last updated
04/01/2008
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