Provider Demographics
NPI:1033374400
Name:THUM, PATRICIA (CRNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:THUM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-1614
Mailing Address - Country:US
Mailing Address - Phone:570-561-2545
Mailing Address - Fax:
Practice Address - Street 1:612 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-1614
Practice Address - Country:US
Practice Address - Phone:570-662-2002
Practice Address - Fax:570-662-2025
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily