Healthcare Provider Details

I. General information

NPI: 1528847571
Provider Name (Legal Business Name): ALINA THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 749495
ATLANTA GA
30374-9495
US

IV. Provider business mailing address

16 SEVAN CT
ASHEVILLE NC
28806-3368
US

V. Phone/Fax

Practice location:
  • Phone: 855-963-2100
  • Fax: 239-236-2775
Mailing address:
  • Phone: 352-219-4380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number321843
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNUR-APRN-LIC-218491
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: