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General NPI Number Information
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NPI Number | 1780327353
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Entity Type | Individual
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Provider Name | JANICE ALTHIA THOMAS FNP
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Gender | Female
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Dates
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Enumeration Date | 04/20/2022
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 3290 SIXES RD
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City | CANTON
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State | GA
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Zip | 30114-9102
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Country | US
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Telephone | 678-374-7514
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Fax | 844-270-4279
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Provider Business Mailing Address
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Address Line | 3333 RIVERWOOD PKWY SE STE 250
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City | ATLANTA
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State | GA
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Zip | 30339-3304
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Country | US
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Telephone | 770-914-0116
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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 | NCO-000001
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN161998
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License Number State | GA
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