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NPI Code Detail

MEDICARE: MRS. EBONIQUE THOMSON FNP

MEDICARE: MRS. EBONIQUE THOMSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN11020262FL
2363LF0000XFamily Nurse PractitionerAP70034986WA
3363LF0000XFamily Nurse Practitioner95034838CA
4363LF0000XFamily Nurse Practitioner0004395CO
5363LF0000XFamily Nurse Practitioner346264NY
6363LF0000XFamily Nurse Practitioner10014312OR
7363LF0000XFamily Nurse Practitioner862214NV
8363LF0000XFamily Nurse Practitioner225873OK
9363LF0000XFamily Nurse Practitioner223100AZ

General Provider Information

NPI Number : 1003375825
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EBONIQUE THOMSON FNP
Provider Business Mailing Address
First Line : 511 N HOLLYWOOD WAY
Second Line :
City : BURBANK
State : CA
Zip : 91505-3406
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 511 N HOLLYWOOD WAY
Second Line :
City : BURBANK
State : CA
Zip : 91505-3406
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2019
Last Update Date : 06/04/2026

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