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Individual

ANDREA MARIE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1930 BISHOP LN FL 12, LOUISVILLE, KY 40218
(502) 456-6200
(502) 456-6655
Mailing address
3532 EPHRAIM MCDOWELL DR, LOUISVILLE, KY 40205-3224
(502) 456-6200
(502) 456-6655

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007644
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50062029
PASSPORT
KY
05
7100263770
KY
Enumeration date
10/12/2012
Last updated
06/05/2018
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