Provider Demographics
NPI:1255468120
Name:THOMPSON, ANNA MARIE (RN, DPHN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN, DPHN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:BELKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, DPHN
Mailing Address - Street 1:30509 SD HIGHWAY 1806
Mailing Address - Street 2:
Mailing Address - City:FORT PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57532-7504
Mailing Address - Country:US
Mailing Address - Phone:605-747-2945
Mailing Address - Fax:
Practice Address - Street 1:400 SOLDIER CREEK RD.
Practice Address - Street 2:
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570-0000
Practice Address - Country:US
Practice Address - Phone:605-747-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR028266163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse