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General NPI Number Information
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NPI Number | 1235489865
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Entity Type | Individual
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Provider Name | KRISTA KAY THOMPSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 700 S PARK ST
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City | MADISON
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State | WI
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Zip | 53715-1830
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Country | US
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Telephone | 608-416-1527
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Fax |
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Provider Business Mailing Address
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Address Line | 204 SAVANNAH ST
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City | BARNEVELD
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State | WI
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Zip | 53507-9608
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Country | US
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Telephone | 608-574-4618
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3025-23
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License Number State | WI
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