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General NPI Number Information
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NPI Number | 1801358163
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Entity Type | Individual
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Provider Name | WILLIAM WAYNE THOMAS II APRN-FPA, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 9520 BONITA BEACH RD SE
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4517
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Country | US
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Telephone | 239-319-2195
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Fax | 239-319-2194
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE FL 2
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City | FORT MYERS
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State | FL
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Zip | 33901-9342
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Country | US
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Telephone | 877-858-6377
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Fax | 239-319-2194
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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 | 277000948
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3013324
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.019260
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11027868
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License Number State | FL
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