Provider Demographics
NPI:1912209214
Name:THOMPSON, NATALIE NICOLE (FNP C)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:NICOLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3413
Mailing Address - Country:US
Mailing Address - Phone:572-616-4757
Mailing Address - Fax:855-939-7173
Practice Address - Street 1:2154 JOHNSON FERRY RD NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-2558
Practice Address - Country:US
Practice Address - Phone:678-732-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA170568363LF0000X, 363L00000X
NC5005259363LF0000X
VA0024182411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily