Provider Demographics
NPI:1700037215
Name:THOMA, KATRINA M (CRNP)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:M
Last Name:THOMA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2421
Mailing Address - Country:US
Mailing Address - Phone:717-960-4325
Mailing Address - Fax:717-960-4373
Practice Address - Street 1:100 N HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2421
Practice Address - Country:US
Practice Address - Phone:717-960-4325
Practice Address - Fax:717-960-4373
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009773363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP009773OtherMEDICAL LICENSE