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General NPI Number Information
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NPI Number | 1144767112
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Entity Type | Individual
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Provider Name | DANIELLE R THOMPSON APN
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Gender | Female
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 2311 COTTMAN AVE STE 71
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1007
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Country | US
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Telephone | 215-444-7505
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Fax | 215-695-2919
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Provider Business Mailing Address
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Address Line | PO BOX 746722
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City | ATLANTA
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State | GA
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Zip | 30374-6722
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR14678000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00695800
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License Number State | NJ
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