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NPI Code Detail

MEDICARE: JENNIFER MARIE THOMPSON FNP-BC

MEDICARE: JENNIFER MARIE THOMPSON FNP-BC
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 Nurse168887TN
2363LF0000XFamily Nurse Practitioner22467TN
3363L00000XNurse Practitioner22467TN

General Provider Information

NPI Number : 1558656157
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIE THOMPSON FNP-BC
Provider Business Mailing Address
First Line : 1100 ENGLAND DR
Second Line :
City : COOKEVILLE
State : TN
Zip : 38501-0924
Country : US
Telephone Number : 931-528-7531
Fax Number :
Provider Business Practice Location Address
First Line : 1503 S MAIN ST
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-5967
Country : US
Telephone Number : 931-484-6196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2011
Last Update Date : 03/14/2018

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