Provider Demographics
NPI:1821166901
Name:THOMPSON, NANCY (CNS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SHEPHERDS LN
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3140
Mailing Address - Country:US
Mailing Address - Phone:908-534-9635
Mailing Address - Fax:
Practice Address - Street 1:1160 RAYMOND BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-4168
Practice Address - Country:US
Practice Address - Phone:973-596-3952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05513200163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health