Individual
MS. ELLEN NADINE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6879 SOUTHPOINT DR N, JACKSONVILLE, FL 32216-6179
(904) 296-2441
(904) 821-3113
Mailing address
PO BOX 16568, JACKSONVILLE, FL 32245-6568
(904) 472-2300
(904) 472-2330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1763212
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305499300
—
FL
01
—
500011594
RAILROAD MEDICARE
FL
01
—
Y8429
BLUECROSS/BLUESHIELD
FL
Enumeration date
10/29/2005
Last updated
10/17/2011
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