Thompson, Lisa Hicks

Thompson, Lisa Hicks is an individual health care provider with primary practice located at 2700 Vissing Park Rd , Jeffersonville IN 47130-5989. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Thompson, Lisa Hicks can be contacted via phone (812) 246-9809.

Contact Information

Primary practice address
2700 Vissing Park Rd Jeffersonville IN 47130-5989
Phone: (812) 246-9809
Fax: (770) 573-9513
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA03855 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10001505A Indiana

Profile Details

NPI number 1376631903
LBN Legal business name Thompson, Lisa Hicks
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Oct 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376631903 NPPES
Indiana MEDICAID 300011148
Indiana MEDICAID 190024301
Indiana MEDICAID 190024302
Indiana MEDICAID 190024303

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