Healthcare Provider Details

I. General information

NPI: 1003495888
Provider Name (Legal Business Name): KATHERINE ANN THOMPSON-MAYES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W TOWNSHIP LINE RD
HAVERTOWN PA
19083-5211
US

IV. Provider business mailing address

429 4TH AVE FL 7
PITTSBURGH PA
15219-1500
US

V. Phone/Fax

Practice location:
  • Phone: 610-242-9164
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN634479
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP023487
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: