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NPI Code Detail

MEDICARE: LAURA M THOMPSON NP-C

MEDICARE: LAURA M THOMPSON NP-C
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
1363L00000XNurse PractitionerNP768AID
2363L00000XNurse PractitionerNP-768AID
3363LA2200XAdult Health Nurse PractitionerA01136 ANPAR
4363LG0600XGerontology Nurse PractitionerA01136 ANPAR
5363LF0000XFamily Nurse Practitioner2017022385MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548205966
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M THOMPSON NP-C
Provider Business Mailing Address
First Line : 54 HOSPITAL DR
Second Line :
City : OSAGE BEACH
State : MO
Zip : 65065-3050
Country : US
Telephone Number : 573-348-8399
Fax Number : 573-348-8309
Provider Business Practice Location Address
First Line : 304A E 4TH ST
Second Line :
City : ELDON
State : MO
Zip : 65026-1808
Country : US
Telephone Number : 573-557-2400
Fax Number : 573-557-2401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/21/2022

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Directions to “ LAURA M THOMPSON NP-C” Practice Location

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