Provider Demographics
NPI:1548484421
Name:THOMPSON, GWENDOLYN BELINDA (STNA)
Entity type:Individual
Prefix:MS
First Name:GWENDOLYN
Middle Name:BELINDA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 RICHMOND PARK E
Mailing Address - Street 2:SUITE 612C
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1833
Mailing Address - Country:US
Mailing Address - Phone:440-446-1658
Mailing Address - Fax:
Practice Address - Street 1:440 RICHMOND PARK E
Practice Address - Street 2:SUITE 612C
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1833
Practice Address - Country:US
Practice Address - Phone:440-446-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered372600000XNursing Service Related ProvidersAdult Companion
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide