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NPI Code Detail

MEDICARE: MRS. MELBA JEAN THOMPSON R.N.

MEDICARE: MRS. MELBA JEAN THOMPSON R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN931622FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN931622OTHERFLSTATE OF FLORIDA REGISTERED NURSE

General Provider Information

NPI Number : 1235397944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELBA JEAN THOMPSON R.N.
Provider Business Mailing Address
First Line : 4020 PARK ST N
Second Line : SUITE 103
City : SAINT PETERSBURG
State : FL
Zip : 33709-4030
Country : US
Telephone Number : 727-345-8614
Fax Number : 727-345-9319
Provider Business Practice Location Address
First Line : 4020 PARK ST N
Second Line : SUITE 103
City : SAINT PETERSBURG
State : FL
Zip : 33709-4030
Country : US
Telephone Number : 727-345-8614
Fax Number : 727-345-9319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2008
Last Update Date : 05/29/2008

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