Thompson, Mitzi B

Thompson, Mitzi B is an individual health care provider with primary practice located at 2460 Nw Stewart Parkway Suite 104, Roseburg OR 97471-1516. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Women's Health is her primary health care specialty. Thompson, Mitzi B can be contacted via phone (541) 677-4463.

Contact Information

Primary practice address
2460 Nw Stewart Parkway Suite 104 Roseburg OR 97471-1516
Phone: (541) 677-4463
Fax: (541) 677-3379
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 201505556NP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X APN 0000005657 Tennessee
Nursing Service Providers / Registered Nurse 163W00000X RN0000055333 Tennessee

Profile Details

NPI number 1912987926
LBN Legal business name Thompson, Mitzi B
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Feb 3rd, 2020 - about 4 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 1912987926 NPPES
Tennessee Other 3905311 MEDICARE-TENNCARE
Tennessee MEDICAID 500695863 MEDICARE-TENNCARE
Tennessee MEDICAID 3905311 MEDICARE-TENNCARE

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