Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 146852 | WI |
Y | 363L00000X | Nurse Practitioner | R 143309-0 | MN |
N | 363LC1500X | Nurse Practitioner - Community Health | 28193028A | IN |
NPI | 1700994712 |
---|---|
Provider Name | Carrie M Thompson |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Minneapolis, MN 55407-1321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00733569 | MEDICARE, RAILROAD (01) | MN |
Q35791 | (02) |