Deandra Marissah Thompson, PA

NPI #1134877939 in Fairfield, Illinois

Provider Information

NPI Number: 1134877939
Entity Type: Individual
Name: Deandra Marissah Thompson, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Mar 11, 2022
Last Updated: Mar 11, 2022

Practice Location

Address: 303 NW 11TH ST
City: Fairfield
State: Illinois
ZIP Code: 62837-1206
Phone: (618) 842-2611

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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