Basic Information
Provider Information
NPI: 1740375922
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMPSON
FirstName: KARIN
MiddleName: T.
NamePrefix:  
NameSuffix:  
Credential: M.S.N., A.P.R.N., CS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12 N RIDGE DR
Address2:  
City: CROMWELL
State: CT
PostalCode: 064161097
CountryCode: US
TelephoneNumber: 8606666951
FaxNumber: 8606676705
Practice Location
Address1: 950 CAMPBELL AVE
Address2:  
City: WEST HAVEN
State: CT
PostalCode: 065162770
CountryCode: US
TelephoneNumber: 2039325711
FaxNumber: 2039374863
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
364SP0808X001241CTY Physician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsych/Mental Health

No ID Information.


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