Provider Demographics
NPI:1609209519
Name:THOMAS, ROSALYN ANDERSON (FNP)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:ANDERSON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 RALPH DAVID ABERNATHY BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1649
Mailing Address - Country:US
Mailing Address - Phone:404-836-0136
Mailing Address - Fax:404-850-8695
Practice Address - Street 1:1325 RALPH DAVID ABERNATHY BLVD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1649
Practice Address - Country:US
Practice Address - Phone:404-836-0136
Practice Address - Fax:404-850-8695
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN169551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily