Healthcare Provider Details

I. General information

NPI: 1629355516
Provider Name (Legal Business Name): CHRISTINA JO THOMPSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 UNIVERSITY AVE
DES MOINES IA
50324-1607
US

IV. Provider business mailing address

739 CUMBERLAND RIDGE WAY
BOWLING GREEN KY
42103-6023
US

V. Phone/Fax

Practice location:
  • Phone: 833-351-8255
  • Fax:
Mailing address:
  • Phone: 615-587-9724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3007215
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: