Provider Demographics
NPI:1265007587
Name:THOMAS, TROYA NAREE
Entity Type:Individual
Prefix:
First Name:TROYA
Middle Name:NAREE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 KNOLLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8515
Mailing Address - Country:US
Mailing Address - Phone:229-886-4646
Mailing Address - Fax:
Practice Address - Street 1:8305 KNOLLBROOK LN
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8515
Practice Address - Country:US
Practice Address - Phone:229-886-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY813853163W00000X, 163WH0500X
GARN227908163WH0500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis