Provider Demographics
NPI:1922129881
Name:THOMPSON, MARY BIALAS (CNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BIALAS
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3788 MONAGHAN POINT RD
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-8856
Mailing Address - Country:US
Mailing Address - Phone:989-595-5227
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1444
Practice Address - Country:US
Practice Address - Phone:989-356-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704120818363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5008767580OtherBCBS