Provider Demographics
NPI:1659333227
Name:THOMLEY, PAUL B (RN, MSN, APN-BC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:THOMLEY
Suffix:
Gender:M
Credentials:RN, MSN, APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1226
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37065-1226
Mailing Address - Country:US
Mailing Address - Phone:615-591-2732
Mailing Address - Fax:615-591-2779
Practice Address - Street 1:1419 NATIONAL HWY
Practice Address - Street 2:MIDWAY PLAZA
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-2319
Practice Address - Country:US
Practice Address - Phone:336-889-7213
Practice Address - Fax:336-889-7216
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51532904OtherBCBS
TN3341229Medicaid
TNP00464603OtherRAILROAD MEDICARE
NC7004126Medicaid
NC2593263Medicare PIN
TN3341229Medicare PIN
TNP00464603OtherRAILROAD MEDICARE
TN3341229Medicaid