Provider Demographics
NPI:1679444814
Name:THOMPSON, ERICA DAWN
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DAWN
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 1:1477 MUD LICK RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-8758
Mailing Address - Country:US
Mailing Address - Phone:907-651-6155
Mailing Address - Fax:
Practice Address - Street 1:8 N SPRING ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2720
Practice Address - Country:US
Practice Address - Phone:304-472-0395
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker