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General NPI Number Information
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NPI Number | 1275006017
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Entity Type | Individual
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Provider Name | KATHERINE THOMSON
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 32 N HIGH ST
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City | BRIDGTON
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State | ME
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Zip | 04009-1125
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Country | US
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Telephone | 207-647-5629
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Fax | 207-647-5620
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Provider Business Mailing Address
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Address Line | PO BOX 241
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City | FREEDOM
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State | NH
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Zip | 03836-0241
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Country | US
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Telephone | 917-204-1313
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 068068-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP181313
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License Number State | ME
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