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General NPI Number Information
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NPI Number | 1184633018
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Entity Type | Individual
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Provider Name | DIANE C THOMAS ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 37203 PECAN ST
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City | HILLIARD
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State | FL
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Zip | 32046-6897
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Country | US
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Telephone | 904-845-4761
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Fax | 904-845-4076
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Provider Business Mailing Address
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Address Line | PO BOX 517
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City | FERNANDINA BEACH
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State | FL
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Zip | 32035-0517
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Country | US
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Telephone | 904-548-1800
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Fax | 904-277-7286
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | ARNP1676512
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License Number State | FL
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