Provider Demographics
NPI:1487756631
Name:THOMPSON, MELBA LEENE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MELBA
Middle Name:LEENE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MAIN ST
Mailing Address - Street 2:UNIT 49
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1600
Mailing Address - Country:US
Mailing Address - Phone:603-659-4747
Mailing Address - Fax:
Practice Address - Street 1:200 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1119
Practice Address - Country:US
Practice Address - Phone:800-892-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04556321163W00000X
NH0455632305363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0455632305OtherARNP NH LICENSE NUMBER
NH04556321OtherREGISTERED NURSE NH LICEN