Provider Demographics
NPI:1386824480
Name:THOMAS, MARGIE A
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:A
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PN086542 IV
Mailing Address - Street 1:1386 VILLAGE WAY
Mailing Address - Street 2:APT 508
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3241
Mailing Address - Country:US
Mailing Address - Phone:440-320-6496
Mailing Address - Fax:419-334-5881
Practice Address - Street 1:1386 VILLAGE WAY
Practice Address - Street 2:APT 508
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3241
Practice Address - Country:US
Practice Address - Phone:440-320-6496
Practice Address - Fax:419-334-5881
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.086542 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse