Provider Demographics
NPI:1447676374
Name:THOMPSON, CHAD (CRNP)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 SWALLOW HILL RD
Mailing Address - Street 2:BLDG. 2600
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1656
Mailing Address - Country:US
Mailing Address - Phone:412-279-4522
Mailing Address - Fax:412-279-3416
Practice Address - Street 1:2275 SWALLOW HILL RD
Practice Address - Street 2:BLDG. 2600
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1656
Practice Address - Country:US
Practice Address - Phone:412-279-4522
Practice Address - Fax:412-279-3416
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006437W207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PATP006437WOtherCRNP LICENSE