MEDICARE: BERYL THOMPSON APRN, FNP

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	363LF0000X	Family Nurse Practitioner	AP140363	TX

General Provider Information

NPI Number	:	1356805956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERYL THOMPSON APRN, FNP

Provider Business Mailing Address
First Line	:	305 W RUSK ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2337
Country	:	US
Telephone Number	:	903-393-3594
Fax Number	:	903-913-7876

Provider Business Practice Location Address
First Line	:	305 W RUSK ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2337
Country	:	US
Telephone Number	:	903-393-3594
Fax Number	:

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

Provider Enumeration Date	:	01/28/2019
Last Update Date	:	12/18/2025

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