Basic Information
Provider Information
NPI: 1033559125
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMPSON
FirstName: STEPHANIE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: WHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1902 S HWY 59
Address2: BLDG E SUITE 301
City: PARSONS
State: KS
PostalCode: 673574948
CountryCode: US
TelephoneNumber: 6208205850
FaxNumber:  
Practice Location
Address1: 1902 S HWY 59
Address2: BLDG E SUITE 301
City: PARSONS
State: KS
PostalCode: 673574948
CountryCode: US
TelephoneNumber: 6208205850
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/03/2013
LastUpdateDate: 07/03/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X147081KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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