Provider Demographics
NPI:1609441823
Name:THOMPSON, TERINEKA (NP)
Entity type:Individual
Prefix:
First Name:TERINEKA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11469 ALTAMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-9043
Mailing Address - Country:US
Mailing Address - Phone:317-201-3380
Mailing Address - Fax:
Practice Address - Street 1:11469 ALTAMOUNT DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040-9043
Practice Address - Country:US
Practice Address - Phone:317-201-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28181422A163W00000X
IN71016333A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse