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General NPI Number Information
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NPI Number | 1417959917
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Entity Type | Individual
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Provider Name | SUEANN THOMAS NP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 2118 25TH ST STE C
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City | COLUMBUS
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State | IN
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Zip | 47201-3240
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Country | US
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Telephone | 812-372-8426
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Fax | 812-378-7777
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Provider Business Mailing Address
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Address Line | 2896 BLUEBELL CT W
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City | COLUMBUS
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State | IN
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Zip | 47201-9399
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71001592A
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License Number State | IN
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