Healthcare Provider Details

I. General information

NPI: 1629987136
Provider Name (Legal Business Name): AMY THOMAS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FAIRVIEW DR
FRANKLIN VA
23851-1214
US

IV. Provider business mailing address

36246 N HEAD LN
FRANKLIN VA
23851-3552
US

V. Phone/Fax

Practice location:
  • Phone: 757-563-6100
  • Fax:
Mailing address:
  • Phone: 757-563-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number0001175026
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: