Healthcare Provider Details

I. General information

NPI: 1184619942
Provider Name (Legal Business Name): CYNTHIA ANN THOMPSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 SKIPWITH RD
RICHMOND VA
23229-5205
US

IV. Provider business mailing address

3308 MERRICK CT
KESWICK VA
22947-9134
US

V. Phone/Fax

Practice location:
  • Phone: 804-289-4937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001102984
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024102984
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: