Basic Information
Provider Information
NPI: 1992281323
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOLIN-THOMPSON
FirstName: SARA
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: DNP, APRN-BC, CNOR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3276
Address2:  
City: EVANSVILLE
State: IN
PostalCode: 477313276
CountryCode: US
TelephoneNumber: 8124730181
FaxNumber: 8124735822
Practice Location
Address1: 3221 FREDERICA ST STE A&B
Address2:  
City: OWENSBORO
State: KY
PostalCode: 423016086
CountryCode: US
TelephoneNumber: 2702157755
FaxNumber: 2702157757
Other Information
ProviderEnumerationDate: 07/18/2018
LastUpdateDate: 05/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X3012444KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
710055809005KY MEDICAID


Home