Healthcare Provider Details

I. General information

NPI: 1144387366
Provider Name (Legal Business Name): JANE MARGARET THOMAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 CLARK RD SUITE 201
SARASOTA FL
34233-3230
US

IV. Provider business mailing address

48 CONRAD COURT
OAKLAND CA
94611-1027
US

V. Phone/Fax

Practice location:
  • Phone: 941-925-3627
  • Fax:
Mailing address:
  • Phone: 510-338-1282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9408914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: