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General NPI Number Information
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NPI Number | 1700069192
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Entity Type | Individual
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Provider Name | NICOLE ANNE THOMPSON NP
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Gender | Female
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Dates
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Enumeration Date | 12/09/2007
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 3003 N CENTRAL AVE SUITE 800
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City | PHOENIX
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State | AZ
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Zip | 85012-2902
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Country | US
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Telephone | 602-384-3328
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 S PLATINUM CT
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City | CHANDLER
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State | AZ
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Zip | 85248-5203
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Country | US
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Telephone | 602-384-3328
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Fax | 480-584-3464
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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 | AP2916
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License Number State | AZ
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