Provider Demographics
NPI:1700416419
Name:THOMAS, ANGELA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 S SEACREST BLVD STE 213
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7944
Mailing Address - Country:US
Mailing Address - Phone:561-536-3166
Mailing Address - Fax:
Practice Address - Street 1:2828 S SEACREST BLVD STE 213
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-536-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily