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Individual

KASEY THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
111 ELLINGTON DR, RAYVILLE, LA 71269-3632
(318) 728-4181
Mailing address
254 HIGHWAY 3048, RAYVILLE, LA 71269-3624
(318) 728-4181

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN106553
LA
363LF0000X
Family Nurse Practitioner
TAP002425
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2130196
LA
Enumeration date
07/27/2010
Last updated
08/30/2019
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