Individual
AMY NICOLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 385-7249
Mailing address
2215 WEBSTER ST, FORT WAYNE, IN 46802-6466
(260) 580-3171
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
28196473A
IN
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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