Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 30512 | SC |
N | 207Q00000X | Family Doctor | MD200008 | LA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2019-02083 | NC |
NPI | 1487607339 |
---|---|
Provider Name | Ms. Lori Ann Thompson |
First Address | Asheville, NC 28803-2318 |
Second Address | Asheville, NC 28803-2318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07085774 | (05) | MS |
1457809 | (05) | LA |
305128 | (05) | SC |
AA27886084 | MEDICARE PIN (01) | SC |
AA27888768 | (02) | SC |