Healthcare Provider Details

I. General information

NPI: 1982542536
Provider Name (Legal Business Name): CHRISTOPHER THOMPSON RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 N 500 W
PROVO UT
84604-3380
US

IV. Provider business mailing address

208 S 975 W
MAPLETON UT
84664-4328
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-5400
  • Fax:
Mailing address:
  • Phone: 801-368-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number12962396-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: