Healthcare Provider Details

I. General information

NPI: 1700175924
Provider Name (Legal Business Name): TONI MARIE THOMAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W CAREFREE HWY
PHOENIX AZ
85085-6093
US

IV. Provider business mailing address

2525 W CAREFREE HWY
PHOENIX AZ
85085-6093
US

V. Phone/Fax

Practice location:
  • Phone: 623-434-5748
  • Fax: 623-434-5751
Mailing address:
  • Phone: 623-434-5748
  • Fax: 623-434-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP3906
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: