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NPI Code Detail

MEDICARE: MS. LISA MICHELLE THOMPSON DNP, PMHNP-BC

MEDICARE: MS. LISA MICHELLE THOMPSON DNP, PMHNP-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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerNP-5179CO
2163W00000XRegistered Nurse164555CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780762385
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA MICHELLE THOMPSON DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 2111 CHAMPA ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2529
Country : US
Telephone Number : 303-291-5160
Fax Number : 303-293-3977
Provider Business Practice Location Address
First Line : 2111 CHAMPA ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2529
Country : US
Telephone Number : 303-291-5160
Fax Number : 303-293-3977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 04/04/2012

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