Individual
MABEL A THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
555 S 43RD ST, PHILADELPHIA, PA 19104-4408
(215) 685-7522
(215) 685-6848
Mailing address
555 S 43RD ST, PHILADELPHIA, PA 19104-4408
(215) 970-4588
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP022271
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952589236
—
PA
Enumeration date
06/08/2021
Last updated
01/16/2023
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