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Provider Information for 1053841361

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MRS. KATIE THOMAS ARNP, FNP-C

Gender: FEMALE

Individual NPI: 1053841361

Calendar   Last Updated:  2021-10-12
  Certification Date:  2021-10-12

Details

Name Value
NPI 1053841361
Enumeration Date 2017-06-19
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4190 PLANTATION OAKS BLVD UNIT 1133
ORANGE PARK, FL 32065-3539
United States

Phone: 904-589-8639 | Fax:
View Map External Link
Primary Practice Address 10150 HIGHLAND MANOR DR STE 240
TAMPA, FL 33610-9750
United States

Phone: 813-259-1013 | Fax: 813-254-0396
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Secondary Practice Address 500 E ADAMS ST
JACKSONVILLE, FL 32202
United States

Phone: 904-630-5813 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LF0000X - Nurse Practitioner Family FL 9282558