Provider Demographics
NPI:1417644071
Name:THOMAS, GEORGIA DENISE (FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:GEORGIA
Middle Name:DENISE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 S BARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2163
Mailing Address - Country:US
Mailing Address - Phone:302-562-6861
Mailing Address - Fax:
Practice Address - Street 1:449 S BARRINGTON CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-2163
Practice Address - Country:US
Practice Address - Phone:302-562-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012330363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily