Provider Demographics
NPI:1407021884
Name:THOMPSON, SUSAN F (WHCNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:F
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12201 RENFERT WAY
Mailing Address - Street 2:#220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5354
Mailing Address - Country:US
Mailing Address - Phone:512-425-3825
Mailing Address - Fax:512-425-3829
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:#220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-425-3825
Practice Address - Fax:512-425-3829
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT1074892363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology