Healthcare Provider Details

I. General information

NPI: 1780807339
Provider Name (Legal Business Name): MARGARET WADDINGTON THOMPSON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 KIEFER BLVD
SACRAMENTO CA
95827-3818
US

IV. Provider business mailing address

9601 KIEFER BLVD
SACRAMENTO CA
95827-3818
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-5015
  • Fax: 916-875-5734
Mailing address:
  • Phone: 916-875-5015
  • Fax: 916-875-5734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP6262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: