Provider Demographics
NPI:1801440615
Name:THOMPSON, MAGAN AMELIA (RN)
Entity type:Individual
Prefix:MS
First Name:MAGAN
Middle Name:AMELIA
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 1:99 PIERPONT AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-2830
Mailing Address - Country:US
Mailing Address - Phone:845-787-4427
Mailing Address - Fax:
Practice Address - Street 1:87 LITTLE BRITAIN RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5113
Practice Address - Country:US
Practice Address - Phone:845-565-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY548564163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse