MEDICARE: MRS. KASEY KRISTEN THOMPSON PA-C

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
1	363A00000X	Physician Assistant	4432	TN

General Provider Information

NPI Number	:	1245821735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KASEY KRISTEN THOMPSON PA-C

Provider Business Mailing Address
First Line	:	3522 CRAWFORD DR SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-0218
Country	:	US
Telephone Number	:	423-453-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 CRAWFORD DR SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37323-0218
Country	:	US
Telephone Number	:	423-453-9000
Fax Number	:	662-883-4198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	07/31/2025

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