Provider Demographics
NPI:1881916203
Name:THOMPSON, ANGELA R (MSN, RN, FNP-C, CDE)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C, CDE
Other - Prefix:
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Mailing Address - Street 1:1000 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1948
Mailing Address - Country:US
Mailing Address - Phone:317-745-3683
Mailing Address - Fax:317-718-4070
Practice Address - Street 1:100 HOSPITAL LN STE 205
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1993
Practice Address - Country:US
Practice Address - Phone:317-745-7445
Practice Address - Fax:317-745-7449
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71003046A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily