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Individual

MARY LOUISE ANN THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP-BC

Contact information

Practice address
1203 LANGHORNE NEWTOWN RD, SUITE 320, LANGHORNE, PA 19047
(215) 750-7818
(215) 752-0436
Mailing address
41 UNIVERSITY DR, SUITE 300, NEWTOWN, PA 18940-1873
(215) 710-5522
(215) 710-5181

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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