Provider Demographics
NPI:1427881663
Name:THOMPSON, DELEQUA A
Entity type:Individual
Prefix:
First Name:DELEQUA
Middle Name:A
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 1:941 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2442
Mailing Address - Country:US
Mailing Address - Phone:614-599-6376
Mailing Address - Fax:614-427-0523
Practice Address - Street 1:941 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2442
Practice Address - Country:US
Practice Address - Phone:614-599-6376
Practice Address - Fax:614-427-0523
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide