Healthcare Provider Details

I. General information

NPI: 1134037724
Provider Name (Legal Business Name): OLIVIA M. THOMPSON PHD, MPH, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8832 DESERT FOX WAY NE
ALBUQUERQUE NM
87122-3647
US

IV. Provider business mailing address

8832 DESERT FOX WAY NE
ALBUQUERQUE NM
87122-3647
US

V. Phone/Fax

Practice location:
  • Phone: 843-830-8788
  • Fax:
Mailing address:
  • Phone: 843-830-8788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberNDP-2026-0142
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: