MEDICARE: NEICA THOMPSON APRN-CNP

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	163W00000X	Registered Nurse	0109332	OK
2	363LF0000X	Family Nurse Practitioner	201888	OK

General Provider Information

NPI Number	:	1386092005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEICA THOMPSON APRN-CNP

Provider Business Mailing Address
First Line	:	2424 SPRINGER DR STE 102
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-3966
Country	:	US
Telephone Number	:	405-216-3747
Fax Number	:	405-920-6420

Provider Business Practice Location Address
First Line	:	2424 SPRINGER DR STE 300
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-3966
Country	:	US
Telephone Number	:	405-216-3747
Fax Number	:	405-339-0377

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

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	04/07/2026

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