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NPI Code Detail

MEDICARE: AMELIA THOMPSON APNP

MEDICARE: AMELIA THOMPSON APNP
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
1363LA2200XAdult Health Nurse Practitioner2579-033WI

General Provider Information

NPI Number : 1841406717
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA THOMPSON APNP
Provider Business Mailing Address
First Line : 5491 WALDEN BAY DR
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-9099
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2917 INTERNATIONAL LN
Second Line :
City : MADISON
State : WI
Zip : 53704-3135
Country : US
Telephone Number : 608-245-3038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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