Provider Demographics
NPI:1912935636
Name:THOMPSON, ANNE BENNETT (CNM)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:BENNETT
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20300 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BRINKLOW
Mailing Address - State:MD
Mailing Address - Zip Code:20862-9726
Mailing Address - Country:US
Mailing Address - Phone:301-774-0937
Mailing Address - Fax:
Practice Address - Street 1:5450 KNOLL NORTH DR
Practice Address - Street 2:SUITE 390
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2300
Practice Address - Country:US
Practice Address - Phone:410-964-4600
Practice Address - Fax:410-740-8654
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR078640367A00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
R12624Medicare UPIN
MD137856ZADTMedicare PIN