Provider Demographics
NPI:1841910197
Name:THOMPSON, WENDY MICHELLE
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3302
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20195-1302
Mailing Address - Country:US
Mailing Address - Phone:202-705-3020
Mailing Address - Fax:
Practice Address - Street 1:11657 CHESTERFIELD CT UNIT C
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3520
Practice Address - Country:US
Practice Address - Phone:202-705-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide