Provider Demographics
NPI:1215665971
Name:THOMPSON, KATANYA NICOLE (CNA)
Entity type:Individual
Prefix:
First Name:KATANYA
Middle Name:NICOLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CRESCENT DR APT 3834
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1991
Mailing Address - Country:US
Mailing Address - Phone:912-755-7182
Mailing Address - Fax:
Practice Address - Street 1:202 CRESCENT DR APT 3834
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-1991
Practice Address - Country:US
Practice Address - Phone:912-755-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide