Individual
ANDREA NICOLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1000 ELEVEN SOUTH 2E, COLUMBIA, IL 62236
(618) 206-6120
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001633
IL
363A00000X
Physician Assistant
2001016022
MO
Other
Enumeration date
08/24/2005
Last updated
02/10/2025
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