Provider Demographics
NPI:1528627981
Name:THOMPSON, MARY KATE (CPM)
Entity type:Individual
Prefix:
First Name:MARY KATE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 E 13TH AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1950
Mailing Address - Country:US
Mailing Address - Phone:630-815-2385
Mailing Address - Fax:
Practice Address - Street 1:1010 E 13TH AVE APT 20
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1950
Practice Address - Country:US
Practice Address - Phone:630-815-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife