Healthcare Provider Details

I. General information

NPI: 1417372400
Provider Name (Legal Business Name): PAMELA JANE THOMPSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3929 AIRPORT BLVD STE 3-307
MOBILE AL
36609-2235
US

IV. Provider business mailing address

3929 AIRPORT BLVD STE 3-307
MOBILE AL
36609-2235
US

V. Phone/Fax

Practice location:
  • Phone: 251-478-8671
  • Fax: 251-478-6174
Mailing address:
  • Phone: 251-478-8671
  • Fax: 251-478-6174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-084120
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: