Most Relevant Information
Provider Data
| NPI Number: | 1003524745 |
| Provider Name: | ANDREA NIKOLE THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 3747A0650X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/11/2022 |
| Last Updated: | 11/11/2022 |
Provider Practice Location
7517 COBAL CANYON LN
LAS VEGAS
NV
891292903
Practice Location Phone/Fax
| Phone: | 7023390356 |
| Fax: |
Provider Mailing Location
7517 COBAL CANYON LN
LAS VEGAS
NV
891292903
Provider Mailing Phone/Fax
| Phone: | 7023390356 |
| Fax: |