Healthcare Provider Details

I. General information

NPI: 1174158539
Provider Name (Legal Business Name): MONICA KRISTINE THOMPSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2020
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 KENMORE AVE STE 1018
ALEXANDRIA VA
22304-1306
US

IV. Provider business mailing address

8613 ROUTE 29 # 200N
FAIRFAX VA
22031-2171
US

V. Phone/Fax

Practice location:
  • Phone: 571-350-8400
  • Fax: 703-823-5723
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-280-9596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024179894
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: