MEDICARE: MRS. KAREN JEAN THOMPSON APRN

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	363L00000X	Nurse Practitioner	RN223647	GA

General Provider Information

NPI Number	:	1891292249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN JEAN THOMPSON APRN

Provider Business Mailing Address
First Line	:	PO BOX 458
Second Line	:
City	:	CAVE SPRING
State	:	GA
Zip	:	30124-0458
Country	:	US
Telephone Number	:	706-749-4900
Fax Number	:	706-749-4901

Provider Business Practice Location Address
First Line	:	15 CEDARTOWN ST SW
Second Line	:	SUITE A
City	:	CAVE SPRING
State	:	GA
Zip	:	30124-2703
Country	:	US
Telephone Number	:	706-749-4900
Fax Number	:	706-749-4901

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

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	12/11/2021

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