Healthcare Provider Details

I. General information

NPI: 1891105466
Provider Name (Legal Business Name): ROBIN THOMPSON RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 INDEPENDENCE
COLUMBUS MS
39710-5300
US

IV. Provider business mailing address

201 INDEPENDENCE
COLUMBUS MS
39710-5300
US

V. Phone/Fax

Practice location:
  • Phone: 662-434-1134
  • Fax:
Mailing address:
  • Phone: 662-434-1134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR859129
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: