Healthcare Provider Details

I. General information

NPI: 1124782040
Provider Name (Legal Business Name): MARJORIE THOMPSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARJORIE DENIS-THOMPSON APRN

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 NW 89TH DR
CORAL SPRINGS FL
33071-6606
US

IV. Provider business mailing address

1301 NW 89TH DR
CORAL SPRINGS FL
33071-6606
US

V. Phone/Fax

Practice location:
  • Phone: 954-282-1743
  • Fax:
Mailing address:
  • Phone: 954-607-9234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015809
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA176692
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP002177
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9474041
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: