Individual
CARLY ELIZABETH THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3322 E BELTLINE CT NE, GRAND RAPIDS, MI 49525-9480
(616) 226-2669
Mailing address
2455 SPRINGSIDE DR, LOWELL, MI 49331-8957
(517) 582-2336
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704298713
MI
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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