Provider Demographics
NPI:1285973800
Name:THOMPSON, JAMES DONALD (RN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DONALD
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S1091 COUNTY ROAD Y
Mailing Address - Street 2:
Mailing Address - City:WONEWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53968-9632
Mailing Address - Country:US
Mailing Address - Phone:160-841-5144
Mailing Address - Fax:
Practice Address - Street 1:S1091 COUNTY ROAD Y
Practice Address - Street 2:
Practice Address - City:WONEWOC
Practice Address - State:WI
Practice Address - Zip Code:53968-9632
Practice Address - Country:US
Practice Address - Phone:160-841-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI156571-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health