Healthcare Provider Details

I. General information

NPI: 1508652983
Provider Name (Legal Business Name): KALEI THOMPSON CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALEI BOWSER

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 DANTIGNAC ST
AUGUSTA GA
30901-2788
US

IV. Provider business mailing address

1238 DANTIGNAC ST
AUGUSTA GA
30901-2788
US

V. Phone/Fax

Practice location:
  • Phone: 706-922-0600
  • Fax: 706-922-0603
Mailing address:
  • Phone: 706-922-0600
  • Fax: 706-922-0603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberGAA-NP005895
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: