Provider Demographics
NPI:1316467749
Name:THOMPSON, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 BRIER CREEK PKWY STE 306
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:883-941-3156
Practice Address - Street 1:7780 BRIER CREEK PKWY STE 306
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8831
Practice Address - Country:US
Practice Address - Phone:919-582-7272
Practice Address - Fax:833-947-3156
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009603363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner