Provider Demographics
NPI:1104605203
Name:THOMPSON, VANESSA ANN (RN)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:ANN
Other - Last Name:SAMPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1107 S SAGINAW RD STE A
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6853
Mailing Address - Country:US
Mailing Address - Phone:989-839-2312
Mailing Address - Fax:
Practice Address - Street 1:1107 S SAGINAW RD STE A
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6853
Practice Address - Country:US
Practice Address - Phone:989-839-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704295840163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse