Thompson, Stacy L

Thompson, Stacy L is an individual health care provider with primary practice located at 1520 N Senate Ave , Indianapolis IN 46202-2213. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Ambulatory Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Thompson, Stacy L can be contacted via phone (317) 962-8893.

Contact Information

Primary practice address
1520 N Senate Ave Indianapolis IN 46202-2213
Fax: (317) 962-6722
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Ambulatory Care 163WP2201X 28207962A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71004728A Indiana

Profile Details

NPI number 1063840759
LBN Legal business name Thompson, Stacy L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2013
Last updated Jan 22nd, 2014 - about 11 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 1063840759 NPPES
Indiana MEDICAID 201200500

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