Provider Demographics
NPI:1629007257
Name:THOMPSON, S. BETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:S. BETH
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2994 KILDAIRE FARM RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9614
Mailing Address - Country:US
Mailing Address - Phone:919-387-1075
Mailing Address - Fax:919-362-6984
Practice Address - Street 1:2994 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9614
Practice Address - Country:US
Practice Address - Phone:919-387-1075
Practice Address - Fax:919-362-6984
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC205865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC#205865OtherNC NURSING LICENSE
NC5001821OtherPRACTICE APPROVAL NUMBER
NC#205865OtherNC NURSING LICENSE