Gaines-Thompson, Vivian

Gaines-Thompson, Vivian is an individual health care provider with primary practice located at 1825 Rockbridge Rd Ste 15B , Stone Mountain GA 30087-3306. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gaines-Thompson, Vivian can be contacted via phone (470) 444-3134.

Contact Information

Primary practice address
1825 Rockbridge Rd Ste 15B Stone Mountain GA 30087-3306
Phone: (470) 444-3134
Fax: (470) 276-4370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28103222A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X GAA-NP000530 Georgia

Profile Details

NPI number 1790197283
LBN Legal business name Gaines-Thompson, Vivian
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2014
Last updated Jan 4th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790197283 NPPES
Indiana Other F0614489 BOARD CERTIFICATION

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