Provider Demographics
NPI:1497975072
Name:THOMPSON, MARYBETH ELEANOR (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARYBETH
Middle Name:ELEANOR
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17408 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3107
Mailing Address - Country:US
Mailing Address - Phone:954-437-5897
Mailing Address - Fax:
Practice Address - Street 1:7390 NW 5TH STREET SUITE 5
Practice Address - Street 2:HAHN & ADLER INTERNAL MEDICINE
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-792-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1043032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily