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General NPI Number Information
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NPI Number | 1134895592
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Entity Type | Individual
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Provider Name | KATHERINE MICHELLE THOMPSON APRN
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Gender | Female
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1055 SAXON BLVD
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City | ORANGE CITY
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State | FL
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Zip | 32763-8468
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Country | US
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Telephone | 386-917-7108
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Fax | 386-917-7293
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 101
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone | 286-231-4519
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Fax | 386-368-8927
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11005706
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License Number State | FL
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