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Individual

DANIELLE M THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
45 BELLEFONTE AVE STE 2, LOCK HAVEN, PA 17745
(570) 858-5328
(570) 858-5355
Mailing address
45 BELLEFONTE AVE STE 2, LOCK HAVEN, PA 17745-1237
(570) 858-5328
(570) 858-5355

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP016775
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103308870
PA
01
599134F6K
MEDICARE
PA
Enumeration date
12/15/2016
Last updated
11/25/2024
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