Provider Demographics
NPI:1073100772
Name:THOMPSON, MOLLIE ELIZABETH (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MOLLIE
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:MOLLIE
Other - Middle Name:
Other - Last Name:SEIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:7916 N 154TH AVE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1820
Mailing Address - Country:US
Mailing Address - Phone:308-380-3892
Mailing Address - Fax:
Practice Address - Street 1:4606 TERRACE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3062
Practice Address - Country:US
Practice Address - Phone:531-299-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72915163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool