Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APN.0993900-NP | CO |
NPI | 1023583176 |
---|---|
Provider Name | Shana Rae Thompson |
First Address | Denver, CO 80238-3984 |
Second Address | Aurora, CO 80045-7211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2018 |
Last Update Date | 04/10/2018 |