Basic Information
| Provider Information | |||||||||
| NPI: | 1881916203 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSN, RN, FNP-C, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177453683 | ||||||||
| FaxNumber: | 3177184070 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL LN STE 205 | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177457445 | ||||||||
| FaxNumber: | 3177457449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2010 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 71003046A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.