Provider Demographics
NPI:1437745528
Name:THOMPSON, ALISON NOEL (FNP-B)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:NOEL
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 HOSPITAL WAY STE A
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201
Mailing Address - Country:US
Mailing Address - Phone:801-266-5633
Mailing Address - Fax:
Practice Address - Street 1:385 ESTELLA AVE
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-1136
Practice Address - Country:US
Practice Address - Phone:208-201-3902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID66047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily