Provider Demographics
NPI:1629848114
Name:THOMPSON, JOSEPH BERTON (RN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BERTON
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 CREEKSIDE PKWY UNIT 111473
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1159
Mailing Address - Country:US
Mailing Address - Phone:239-330-7096
Mailing Address - Fax:
Practice Address - Street 1:299 BURNT PINE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9752
Practice Address - Country:US
Practice Address - Phone:239-330-7096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9437075163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice