Provider Demographics
NPI:1538323886
Name:THOMAS, MARY LOUISE ANN (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:MARY LOUISE
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ACNP-BC
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Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 320
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-750-7818
Practice Address - Fax:215-752-0436
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAUP006155B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3694091OtherCIGNA PA
PAP01424483OtherRAILROAD MEDICARE
PA4839939OtherAETNA
PA1030158410001Medicaid
PA30227319OtherKEYSTONE FIRST
PA3114456OtherHIGHMARK BLUE SHIELD
PA4839939OtherAETNA