Provider Demographics
NPI:1184694119
Name:THOMPSON, KAY (CRNP)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 TECHNOLOGY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9531
Mailing Address - Country:US
Mailing Address - Phone:724-531-2902
Mailing Address - Fax:724-531-2948
Practice Address - Street 1:151 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4378
Practice Address - Country:US
Practice Address - Phone:724-222-7240
Practice Address - Fax:724-222-5778
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006129C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103689463Medicaid
039539Medicare ID - Type Unspecified