Provider Demographics
NPI:1710862545
Name:THOMPSON, NOELLE
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 MAIN ST APT 1523
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1679
Mailing Address - Country:US
Mailing Address - Phone:513-702-8245
Mailing Address - Fax:
Practice Address - Street 1:3131 MAIN ST APT 1523
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1679
Practice Address - Country:US
Practice Address - Phone:513-702-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program