Most Relevant Information
Provider Data
| NPI Number: | 1003538117 |
| Provider Name: | NIKITA MARIE THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/15/2022 |
| Last Updated: | 09/15/2022 |
Provider Practice Location
325 N STATE OF FRANKLIN RD
JOHNSON CITY
TN
376046056
Practice Location Phone/Fax
| Phone: | 4234336757 |
| Fax: |
Provider Mailing Location
325 N STATE OF FRANKLIN RD
JOHNSON CITY
TN
376046056
Provider Mailing Phone/Fax
| Phone: | 4234336757 |
| Fax: |