Provider Demographics
NPI:1780714840
Name:THOMPSON, ROSEANNE K (CRNP)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:201 PROSPECT BAY DR E
Mailing Address - Street 2:
Mailing Address - City:GRASONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21638-1180
Mailing Address - Country:US
Mailing Address - Phone:410-263-6363
Mailing Address - Fax:410-263-4086
Practice Address - Street 1:200 FORBES ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1538
Practice Address - Country:US
Practice Address - Phone:410-263-6363
Practice Address - Fax:410-263-4086
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR048823363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR048823OtherSTATE LICENSE
MDN46663OtherST CONTROLLED SUBSTANCE