Provider Demographics
NPI:1821169467
Name:THOMPSON, MAUREEN ANN (FNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:A
Other - Last Name:BRYAN THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-0655
Mailing Address - Country:US
Mailing Address - Phone:603-642-3910
Mailing Address - Fax:
Practice Address - Street 1:53 CHURCH ST
Practice Address - Street 2:UNIT 14
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-9997
Practice Address - Country:US
Practice Address - Phone:603-642-3910
Practice Address - Fax:603-642-3940
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH032993-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP09470Medicare UPIN
NP2506Medicare ID - Type UnspecifiedFEDERAL
MA81053OtherFALLON COMMUNITY HEALTH
MANP2506OtherBLUE CROSS BLUE SHIELD