Criss, Charlene Roberta Thompson

Criss, Charlene Roberta Thompson is an individual health care provider with primary practice located at 15 Mohegan Ave Uscg Academy Clinic, New London CT 06320. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Criss, Charlene Roberta Thompson can be contacted via phone (860) 701-6737.

Contact Information

Primary practice address
15 Mohegan Ave Uscg Academy Clinic New London CT 06320
Phone: (860) 701-6737
Fax: (860) 701-6475
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1710 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001831 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MP00120900 New Jersey

Profile Details

NPI number 1760469514
LBN Legal business name Criss, Charlene Roberta Thompson
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Apr 29th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1760469514 NPPES
Other 1051820 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
Other 001831 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS

Popular Providers