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Individual
MARY LOUISE ANN THOMAS
Active
Individual
MARY LOUISE ANN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
UP006155B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030158410001
—
PA
01
—
30227319
KEYSTONE FIRST
PA
01
—
3114456
HIGHMARK BLUE SHIELD
PA
01
—
3694091
CIGNA PA
PA
01
—
4839939
AETNA
PA
01
—
P01424483
RAILROAD MEDICARE
PA
Enumeration date
07/16/2008
Last updated
05/14/2021
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