Provider Demographics
NPI:1467031898
Name:THOMPSON, INGRID PATRICIA (APRN)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:PATRICIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 CORAL RIDGE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-4144
Mailing Address - Country:US
Mailing Address - Phone:954-465-3189
Mailing Address - Fax:
Practice Address - Street 1:930 CORAL RIDGE DR APT 102
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-4144
Practice Address - Country:US
Practice Address - Phone:954-465-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily