Provider Demographics
NPI:1962129866
Name:EDWARD P. THOMPSON NURSE PRACTITIONER OF PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:EDWARD P. THOMPSON NURSE PRACTITIONER OF PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER IN PSYCHIATRY
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:PALMER
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP, PMHNP-BC
Authorized Official - Phone:251-406-2269
Mailing Address - Street 1:262 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2432
Mailing Address - Country:US
Mailing Address - Phone:251-406-2269
Mailing Address - Fax:
Practice Address - Street 1:262 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2432
Practice Address - Country:US
Practice Address - Phone:251-406-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty