Thompson, Staci Renee

Thompson, Staci Renee is an individual health care provider with primary practice located at 6015 Pointe West Blvd , Bradenton FL 34209-5525. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Thompson, Staci Renee can be contacted via phone (941) 792-1404.

Contact Information

Primary practice address
6015 Pointe West Blvd Bradenton FL 34209-5525
Phone: (941) 792-1404
Fax: (941) 795-1717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9169001 Florida

Profile Details

NPI number 1982821757
LBN Legal business name Thompson, Staci Renee
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Feb 12th, 2015 - about 9 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 1982821757 NPPES
Florida MEDICAID 308776000
Florida Other Y140P

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