=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508565235
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER BROOKE THOMPSON APRN, FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2023
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 104 MAIN ST
-----------------------------------------------------
City | LOGAN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25601-3607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-752-9450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 MAIN ST
-----------------------------------------------------
City | LOGAN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25601-3607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-752-9450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 89155
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 115636
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------