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General NPI Number Information
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NPI Number | 1861027765
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Entity Type | Individual
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Provider Name | ANGELA TAYLOR THOMPSON LPN
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 215 DAYTON MOUNTAIN HWY
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City | DAYTON
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State | TN
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Zip | 37321-1047
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Country | US
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Telephone | 423-428-9291
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Fax | 423-428-9281
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Provider Business Mailing Address
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Address Line | 1629 RAILROAD ST STE 2
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City | DAYTON
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State | TN
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Zip | 37321-2049
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Country | US
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Telephone | 423-428-9192
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Fax | 423-428-9281
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 76148
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License Number State | TN
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