Healthcare Provider Details

I. General information

NPI: 1356951693
Provider Name (Legal Business Name): CASEY JEAN MORNINGSTAR THOMPSON NP-C, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASEY JEAN MORNINGSTAR THOMPSON

II. Dates (important events)

Enumeration Date: 08/02/2020
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N PARROTT AVE
OKEECHOBEE FL
34972-2103
US

IV. Provider business mailing address

16625 NW 203RD ST
OKEECHOBEE FL
34972-0458
US

V. Phone/Fax

Practice location:
  • Phone: 888-570-4325
  • Fax:
Mailing address:
  • Phone: 772-519-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9297709
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11010909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: