Individual
SUEANN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2118 25TH ST STE C, COLUMBUS, IN 47201-3240
(812) 372-8426
(812) 378-7777
Mailing address
2896 BLUEBELL CT W, COLUMBUS, IN 47201-9399
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001592A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000990887
ANTHEM PIN
IN
01
—
144670
MEDICARE GROUP NUMBER
IN
01
—
1790837789
GROUP NPI NUMBER
IN
05
—
200511580
—
IN
Enumeration date
08/15/2005
Last updated
09/06/2024
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