Provider Demographics
NPI:1104580877
Name:THOMPSON, BRENT WESLEY (PHD RN)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:WESLEY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PHD RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 E BASIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-4200
Mailing Address - Country:US
Mailing Address - Phone:302-429-4085
Mailing Address - Fax:302-429-4097
Practice Address - Street 1:318 E BASIN RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4200
Practice Address - Country:US
Practice Address - Phone:302-429-4085
Practice Address - Fax:302-429-4097
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0015012163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool