Individual
KIM LILLY THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1435 S OSPREY AVE STE 200, SARASOTA, FL 34239-2905
(941) 404-5453
(941) 279-3145
Mailing address
4360 47TH ST, SARASOTA, FL 34235-4408
(313) 720-3358
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11019249
FL
363LG0600X
Gerontology Nurse Practitioner
4704294325
MI
Other
Enumeration date
04/24/2017
Last updated
09/06/2024
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