Healthcare Provider Details

I. General information

NPI: 1306491246
Provider Name (Legal Business Name): MARGARET ANNA THOMAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 MAIN ST
JASPER TN
37347-1109
US

IV. Provider business mailing address

2768 FOREST RD
CHATTANOOGA TN
37406-1109
US

V. Phone/Fax

Practice location:
  • Phone: 423-651-1696
  • Fax: 423-651-1697
Mailing address:
  • Phone: 770-713-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000026177
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN195589
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: