MRS. MYSTIC MICHELLE THOMPSON (NPI# 1851568315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851568315 |
Entity Type | Individual |
Full Name | MRS. MYSTIC MICHELLE THOMPSON |
Practice Address |
3223 E Broadway St North Little Rock AR 72114-6344 |
Practice Telephone | 5019455544 |
Practice Fax Number | 5019455546 |
Mailing Telephone | 5019455544 |
Mailing Fax Number | 5019455546 |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R67979 | AR | Nursing Service Providers |
Street Address |
3223 E BROADWAY ST |
City | NORTH LITTLE ROCK |
State | AR |
Zip Code | 72114-6344 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114109147 | Ronald Kirby | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2007-11-30 |
1649447129 | Jeffrey Reed | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2008-05-13 |
1578738761 | Kimberly Robinson | Social Worker | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2008-04-28 |
1427229079 | Marissa K Jones | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2008-03-21 |
1083885636 | Peggy J James | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2008-03-21 |
1760650642 | People Advocating Transitions | Case Management | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2008-02-13 |
1659554640 | Tfs of Gurdon Inc | Case Management | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2007-12-12 |
1912189622 | Patrick Randolph | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2007-12-04 |
1720260433 | Allen Phillips | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2007-12-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
1598071490 | Roger Elliott Hicks IIi | Counselor | 2200 Fort Roots Dr # 3d, North Little Rock, AR 72114 | 2010-08-30 |
1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
Find all providers in zip 72114 |
Taxonomy Code | 163WP0808X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851664874 | Mary Ann Sullivan | Registered Nurse | 1901 Main St, North Little Rock, AR 72114-2831 | 2012-02-22 |
1205132636 | Rosalynn Denise Mcgill | Registered Nurse | 4354 Stockton Dr, North Little Rock, AR 72117-2917 | 2011-02-02 |
1376869065 | Donna Bingley | Registered Nurse | 4702 W Commercial Dr, North Little Rock, AR 72116-7068 | 2010-04-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518434745 | Shawnte Marie Farmer | Registered Nurse | 910 Nw 7th St Ste 6, Bentonville, AR 72712-4565 | 2018-10-25 |
1346789948 | Watkins Family Health & Counseling, Inc. | Registered Nurse | 10345 W Jeter Rd, Fayetteville, AR 72701-9382 | 2017-02-15 |
1841740115 | Kelsey Morgan Sallee | Registered Nurse | 4004 Massard Rd, Fort Smith, AR 72903-6222 | 2016-10-10 |
1982060562 | Buffalo River Clinic Inc | Registered Nurse | 933 Mc 6013, Yellville, AR 72687-7595 | 2016-01-12 |
1164805636 | Teressa Lynn Barnes | Registered Nurse | 810 N. Hutchinson St., Pine Bluff, AR 71602-4644 | 2015-07-02 |
1215194055 | Darin Paul Morgan | Registered Nurse | 1014 Autumn Rd Ste 3, Little Rock, AR 72211-3768 | 2008-05-20 |
1497922868 | Jacqueline Regina Love-ryan | Registered Nurse | 620 S Laurel, Pine Bluff, AR 71601-4859 | 2008-05-14 |
1669664975 | Lori Jean Cline | Registered Nurse | 2322 Gunpowder Rd, Little Rock, AR 72227-3025 | 2007-08-10 |
1588709646 | Perspectives Behavioral Health Management, LLC | Registered Nurse | 115 Fort St, Barling, AR 72923-2646 | 2007-02-20 |
1407910680 | Susan Lowrey | Registered Nurse | 4601 W 7th St, Little Rock, AR 72205-5441 | 2006-12-21 |
Find all providers with the same taxonomy |
City | NORTH LITTLE ROCK |
Zip Code | 72114 |
Please comment or provide details below to improve the information on MRS. MYSTIC MICHELLE THOMPSON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.