Provider Demographics
NPI:1275088668
Name:THOMPSON, ASHLEY NICOLE (FNP - BC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03284-0364
Mailing Address - Country:US
Mailing Address - Phone:415-580-0806
Mailing Address - Fax:
Practice Address - Street 1:95 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3103
Practice Address - Country:US
Practice Address - Phone:415-580-0806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20885363LF0000X
TN21569363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ023854Medicaid
TN1035I00135Medicare PIN