Provider Demographics
NPI:1306849385
Name:THOMAN, ANDREA M (CPNP, APRN)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:THOMAN
Suffix:
Gender:F
Credentials:CPNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 DZEN WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2098
Mailing Address - Country:US
Mailing Address - Phone:860-432-8335
Mailing Address - Fax:
Practice Address - Street 1:357 HARTFORD TPKE
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4838
Practice Address - Country:US
Practice Address - Phone:860-871-2102
Practice Address - Fax:860-870-0890
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0003334363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics