Provider Demographics
NPI:1871586370
Name:THOMPSON, NANCY C (CRNA)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 NORTH SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1700
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-217-4218
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN141763L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001964075 0004Medicaid
PAG920-0090/85XWCUOtherCAREFIRST
PA0019640750002Medicaid
PA25-1716306OtherHEALTHNET/TRICARE
PA253379OtherUNISON
PA25-1716306OtherFIRST HEALTH
PAP00458428OtherRAILROAD MEDICARE
1007307260035OtherMEDICAID GROUP #
PA50075252OtherCAPITAL BLUECROSS
PA050514OtherMEDICARE GROUP #
PA120420418OtherDEPT OF LABOR
PAPEARL PROVIDEROtherHEALTH AMERICA
PARN141763LOtherLICENSE
PA001964075 0003Medicaid
PA013281P1KMedicare PIN