Healthcare Provider Details

I. General information

NPI: 1225330376
Provider Name (Legal Business Name): KATHRYNN SUE THOMPSON MS, RN, PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 11/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W 10TH AVE
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

300 WEST 10TH AVENUE M200 STARLING-LOVING HALL
COLUMBUS OH
43210
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-3237
  • Fax: 614-293-6037
Mailing address:
  • Phone: 614-293-3237
  • Fax: 614-293-6037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN 138887 NS-01815
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: