Provider Demographics
NPI:1194562777
Name:THOMPSON, LINDA (MSN, RN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 CHAMPION CITY RD
Mailing Address - Street 2:
Mailing Address - City:GERALD
Mailing Address - State:MO
Mailing Address - Zip Code:63037-2833
Mailing Address - Country:US
Mailing Address - Phone:314-691-4564
Mailing Address - Fax:
Practice Address - Street 1:8370 CHAMPION CITY RD
Practice Address - Street 2:
Practice Address - City:GERALD
Practice Address - State:MO
Practice Address - Zip Code:63037-2833
Practice Address - Country:US
Practice Address - Phone:314-691-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO131696163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health