Provider Demographics
NPI:1053316604
Name:THOMAS, JONALEA W (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JONALEA
Middle Name:W
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4126 N HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3536
Practice Address - Country:US
Practice Address - Phone:419-517-7600
Practice Address - Fax:419-517-7598
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA07572-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2503718Medicaid
OHH140660Medicare PIN
OHQ17320Medicare UPIN