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General NPI Number Information
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NPI Number | 1902542848
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Entity Type | Individual
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Provider Name | ASHLEY MEGAN THOMPSON
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Gender | Female
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 1012 MARTIN LUTHER KING DR
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City | MARKS
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State | MS
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Zip | 38646-1832
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Country | US
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Telephone | 662-326-3502
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Fax |
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Provider Business Mailing Address
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Address Line | 545 DEER RUN RD
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City | BATESVILLE
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State | MS
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Zip | 38606-8655
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Country | US
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Telephone | 662-619-0077
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R879071
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 905354
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License Number State | MS
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