MEDICARE: TANASIA CHICOLE THOMAS MPH, MSN, APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11020179	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11020179	FL
3	363LF0000X	Family Nurse Practitioner	F356962	NY

General Provider Information

NPI Number	:	1013647452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANASIA CHICOLE THOMAS MPH, MSN, APRN

Provider Business Mailing Address
First Line	:	7210 MANATEE AVE W # 1011
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3439
Country	:	US
Telephone Number	:	941-580-0213
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 MANATEE AVE W # 1011
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3439
Country	:	US
Telephone Number	:	941-580-0213
Fax Number	:	941-580-0213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	04/02/2026

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