Healthcare Provider Details

I. General information

NPI: 1437017787
Provider Name (Legal Business Name): JESSICA PAIGE THOMPSON RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 CABRIC DR
SAINT CHARLES MO
63301-5027
US

IV. Provider business mailing address

2304 CABRIC DR
SAINT CHARLES MO
63301-5027
US

V. Phone/Fax

Practice location:
  • Phone: 309-231-6163
  • Fax:
Mailing address:
  • Phone: 309-231-6163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number2015011122
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: