Provider Demographics
NPI:1871345124
Name:THOMPSON-ROBERTS, STEPHANIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:THOMPSON-ROBERTS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 940212
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-7212
Mailing Address - Country:US
Mailing Address - Phone:832-714-4369
Mailing Address - Fax:
Practice Address - Street 1:24131 WANDERING BROOK DR
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-2293
Practice Address - Country:US
Practice Address - Phone:832-714-4369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX712593163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management