Provider Demographics
NPI:1508565235
Name:THOMPSON, AMBER BROOKE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:BROOKE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:WV
Mailing Address - Zip Code:25625-0173
Mailing Address - Country:US
Mailing Address - Phone:304-946-1549
Mailing Address - Fax:
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 509
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1226
Practice Address - Country:US
Practice Address - Phone:304-388-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV89155363LF0000X
WV115636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily