Provider Demographics
NPI:1942027586
Name:THOMPSON, LAURA CAROL (PMH-NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CAROL
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1364 E WELDONA WAY
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8072
Mailing Address - Country:US
Mailing Address - Phone:317-437-7118
Mailing Address - Fax:
Practice Address - Street 1:4440 ARAPAHOE AVE STE 220
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-9101
Practice Address - Country:US
Practice Address - Phone:303-395-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-RXN.0101937-C-NP2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry