MEDICARE: COLLEEN THOMPSON ARNP

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
1	363LF0000X	Family Nurse Practitioner	ARNP9228475	FL

General Provider Information

NPI Number	:	1013018522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN THOMPSON ARNP

Provider Business Mailing Address
First Line	:	1335 MELALEUCA LANE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5921
Country	:	US
Telephone Number	:	239-849-5441
Fax Number	:

Provider Business Practice Location Address
First Line	:	3830 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8193
Country	:	US
Telephone Number	:	239-939-2808
Fax Number	:	239-939-4794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	04/19/2012

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