MEDICARE: GENE DOLORES THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN128517	AZ

General Provider Information

NPI Number	:	1184213043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENE DOLORES THOMPSON

Provider Business Mailing Address
First Line	:	7310 W MESQUITE RIVER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-5130
Country	:	US
Telephone Number	:	520-240-3609
Fax Number	:

Provider Business Practice Location Address
First Line	:	7310 W MESQUITE RIVER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-5130
Country	:	US
Telephone Number	:	520-240-3609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	01/14/2021

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Directions to “ GENE DOLORES THOMPSON ” Practice Location

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