MEDICARE: TERESA THOMPSON APRN

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	363LA2200X	Adult Health Nurse Practitioner	APRN9243845	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629480603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA THOMPSON APRN

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-9560
Fax Number	:	239-343-9624

Provider Business Practice Location Address
First Line	:	8925 COLONIAL CENTER DR STE 1000
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905
Country	:	US
Telephone Number	:	239-343-9560
Fax Number	:	239-343-9624

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

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2026

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