Provider Demographics
NPI:1225261019
Name:THOMPSON, ELIZABETH NIMMICH (CRNP-A)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NIMMICH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNP-A
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:NIMMICH
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:826 WASHINGTON RD.
Mailing Address - Street 2:SUITE 121
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5779
Mailing Address - Country:US
Mailing Address - Phone:410-751-2510
Mailing Address - Fax:410-751-2515
Practice Address - Street 1:3700 ODONNELL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5269
Practice Address - Country:US
Practice Address - Phone:773-292-4800
Practice Address - Fax:312-564-4059
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174104363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health