Individual
LUCY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 CHERRY ST SE STE 306, GRAND RAPIDS, MI 49503-4607
(616) 685-8750
(616) 685-8002
Mailing address
PO BOX 776974, CHICAGO, IL 60677-6974
(231) 672-2119
(313) 432-7759
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704330108
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851922405
—
MI
Enumeration date
02/03/2020
Last updated
06/01/2023
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