Provider Demographics
NPI:1184981755
Name:THOMPSON, CARLIE ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:CARLIE
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 HIGHSPIRE RD
Mailing Address - Street 2:
Mailing Address - City:ROMANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4796
Mailing Address - Country:US
Mailing Address - Phone:610-306-4098
Mailing Address - Fax:
Practice Address - Street 1:870 E BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1842
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000604363LF0000X
PASP012921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily