Provider Demographics
NPI:1346663820
Name:THOMPSON, MICHELLE JOYCE (MSN, APRN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JOYCE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:JOYCE
Other - Last Name:SIEMENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 991844
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-1844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2175 ROSALINE AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2549
Practice Address - Country:US
Practice Address - Phone:530-225-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013872363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIAPRN2098OtherHAWAII BOARD OF NURSING
HIRN00487OtherHAWAII NARCOTICS ENFORCEMENT DIVISION
HIRN82838OtherHAWAII BOARD OF NURSING
HIRN82838OtherHAWAII BOARD OF NURSING