| NPI | 1164088977 |
|---|---|
| Former Name | AMANDA FAYE THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA GAA-NP000337) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11002465) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2021-12-02 |