Provider Demographics
NPI:1093886608
Name:THORNTON, WILLIAM ANDREW (APRN-BC, FNP)
Entity Type:Individual
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First Name:WILLIAM
Middle Name:ANDREW
Last Name:THORNTON
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Gender:M
Credentials:APRN-BC, FNP
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Mailing Address - Street 1:1601 WEHUNT PL SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4845
Mailing Address - Country:US
Mailing Address - Phone:678-761-4106
Mailing Address - Fax:770-432-1648
Practice Address - Street 1:3720 DAVINCI CT
Practice Address - Street 2:SUITE 400
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-7627
Practice Address - Country:US
Practice Address - Phone:678-628-0371
Practice Address - Fax:770-582-4189
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2015-08-04
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Provider Licenses
StateLicense IDTaxonomies
GARN166395-NP363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA269139867BMedicaid
GA50BBHNGMedicare UPIN