Provider Demographics
NPI:1992014641
Name:THOMPSON, ANGELA DENISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DENISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 BRUNSWICK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3901
Mailing Address - Country:US
Mailing Address - Phone:513-693-2144
Mailing Address - Fax:
Practice Address - Street 1:539 BRUNSWICK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3901
Practice Address - Country:US
Practice Address - Phone:513-693-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 358265163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse