Provider Demographics
NPI:1356574875
Name:THOMPSON, LUCIANE D
Entity type:Individual
Prefix:
First Name:LUCIANE
Middle Name:D
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 CURTIS IVEY RD
Mailing Address - Street 2:
Mailing Address - City:TURKEY
Mailing Address - State:NC
Mailing Address - Zip Code:28393-9061
Mailing Address - Country:US
Mailing Address - Phone:910-533-2312
Mailing Address - Fax:
Practice Address - Street 1:211 VANCE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4040
Practice Address - Country:US
Practice Address - Phone:910-299-0330
Practice Address - Fax:910-299-0333
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3872163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health