Provider Demographics
NPI:1104206879
Name:THOMPSON, ALENA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALENA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGERVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:85938-5104
Mailing Address - Country:US
Mailing Address - Phone:928-333-7333
Mailing Address - Fax:928-333-7157
Practice Address - Street 1:118 S MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGERVILLE
Practice Address - State:AZ
Practice Address - Zip Code:85938-5104
Practice Address - Country:US
Practice Address - Phone:928-333-7333
Practice Address - Fax:928-333-7157
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN210400OtherARIZONA STATE BOARD OF NURSING RN NUMBER
AZAP10558OtherARIZONA STATE BOARD OF NURSING NP NUMBER
AZRN210400OtherARIZONA STATE BOARD OF NURSING RN NUMBER
AZAP10558OtherARIZONA STATE BOARD OF NURSING NP NUMBER