Provider Demographics
NPI:1669668372
Name:THOMPSON, NICOLE MICHELLE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 U.S. HIGHWAY #1
Mailing Address - Street 2:SUITE 235
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3884
Mailing Address - Country:US
Mailing Address - Phone:561-626-2006
Mailing Address - Fax:561-624-9718
Practice Address - Street 1:840 U.S. HIGHWAY #1
Practice Address - Street 2:SUITE 235
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3884
Practice Address - Country:US
Practice Address - Phone:561-626-2006
Practice Address - Fax:561-624-9718
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2993372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 2993372OtherLICENSE NUMBER