Provider Demographics
NPI:1972213882
Name:THOMPSON, NATALIE ANNE (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:FAIVRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:101 INDUSTRY RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:62417-2442
Mailing Address - Country:US
Mailing Address - Phone:618-945-3001
Mailing Address - Fax:
Practice Address - Street 1:101 INDUSTRY RD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:IL
Practice Address - Zip Code:62417-2442
Practice Address - Country:US
Practice Address - Phone:618-945-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.026491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily