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General NPI Number Information
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NPI Number | 1821355876
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Entity Type | Individual
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Provider Name | MARCY LYNN THOMAS NP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 11333 COUNTY ROAD 2
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City | MIDDLEBURY
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State | IN
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Zip | 46540-9632
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Country | US
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Telephone | 574-825-8000
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Fax | 574-260-9580
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Provider Business Mailing Address
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Address Line | 11333 COUNTY ROAD 2
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City | MIDDLEBURY
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State | IN
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Zip | 46540-9632
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Country | US
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Telephone | 574-825-8000
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Fax | 574-260-9580
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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 | 71003934A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 71003934A
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License Number State | IN
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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 | 71003934A
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License Number State | IN
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