Healthcare Provider Details

I. General information

NPI: 1306173778
Provider Name (Legal Business Name): TERRI D THOMPSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRI D HEATH

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 LONE OAK RD SUITE 310
PADUCAH KY
42003-7913
US

IV. Provider business mailing address

PO BOX 636961
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 270-443-0777
  • Fax: 270-443-0999
Mailing address:
  • Phone: 513-981-5098
  • Fax: 513-981-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3006242
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: