Provider Demographics
NPI:1962188219
Name:THOMPSON, CAROLYN DENICE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:DENICE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 BEACON POINTE LN
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8399
Mailing Address - Country:US
Mailing Address - Phone:832-382-5442
Mailing Address - Fax:
Practice Address - Street 1:914 FM 517 RD W STE 222
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3924
Practice Address - Country:US
Practice Address - Phone:346-399-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126573363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health