Provider Demographics
NPI:1962781518
Name:THOMPSON, KIMBERLY ADLER (CRNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ADLER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANNE
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-415-1475
Mailing Address - Fax:251-415-1476
Practice Address - Street 1:1720 CENTER ST
Practice Address - Street 2:103
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3304
Practice Address - Country:US
Practice Address - Phone:251-415-1475
Practice Address - Fax:251-415-1476
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-107973363LP0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics