Provider Demographics
NPI:1548901192
Name:THOMPSON, BRENDA LORRAINE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LORRAINE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 SCHOONER ST
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4051
Mailing Address - Country:US
Mailing Address - Phone:207-563-4250
Mailing Address - Fax:
Practice Address - Street 1:79 SCHOONER ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4051
Practice Address - Country:US
Practice Address - Phone:207-563-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP221108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine