| NPI | 1073815742 |
|---|---|
| Former Name | JADIE LYNNE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1932) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA 200401) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2011-05-02 |