Healthcare Provider Details

I. General information

NPI: 1487134474
Provider Name (Legal Business Name): ARIANA THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 COUNTY HIGHWAY I
CHIPPEWA FALLS WI
54729-1423
US

IV. Provider business mailing address

3240 AVALON BLVD
CONYERS GA
30013-6320
US

V. Phone/Fax

Practice location:
  • Phone: 715-746-4200
  • Fax:
Mailing address:
  • Phone: 770-860-1133
  • Fax: 770-860-1941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number104090
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN231647
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: