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General NPI Number Information
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NPI Number | 1164079828
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Entity Type | Individual
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Provider Name | IVY ELIZABETH THOMPSON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 800 N DUPONT BLVD
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City | MILFORD
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State | DE
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Zip | 19963-1019
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Country | US
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Telephone | 302-430-5705
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Fax | 302-430-5679
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Provider Business Mailing Address
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Address Line | 800 N DUPONT BLVD
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City | MILFORD
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State | DE
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Zip | 19963-1019
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Country | US
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Telephone | 302-450-3481
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Fax | 302-430-5679
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 104266
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0012661
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License Number State | DE
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