Individual
CHERYL THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
711 E MISSOURI AVE, PHOENIX, AZ 85014-2841
(602) 433-1200
Mailing address
13035 W VIA CAMILLE, EL MIRAGE, AZ 85335-5309
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP010765
AZ
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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