1992281323 NPI number — DR. SARA LYNN DOOLIN-THOMPSON DNP, APRN-BC, CNOR

Table of content: DR. SARA LYNN DOOLIN-THOMPSON DNP, APRN-BC, CNOR (NPI 1992281323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992281323 NPI number — DR. SARA LYNN DOOLIN-THOMPSON DNP, APRN-BC, CNOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOOLIN-THOMPSON
Provider First Name:
SARA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, APRN-BC, CNOR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992281323
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3221 FREDERICA ST STE A&B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWENSBORO
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42301-6086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-215-7755
Provider Business Mailing Address Fax Number:
270-215-7757

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3221 FREDERICA ST STE A&B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42301-6086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-215-7755
Provider Business Practice Location Address Fax Number:
270-215-7757
Provider Enumeration Date:
07/18/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  3012444 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100558090 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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