Provider Demographics
NPI:1538896899
Name:THOMSON, CARRIE PACE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:PACE
Last Name:THOMSON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10728 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-4636
Mailing Address - Country:US
Mailing Address - Phone:702-236-7436
Mailing Address - Fax:
Practice Address - Street 1:12300 LAS VEGAS BLVD S
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-9506
Practice Address - Country:US
Practice Address - Phone:702-837-1265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV857152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily