Provider Demographics
NPI:1851792493
Name:THOMAS, ANNE W (CRNA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:W
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 WOODWIND DR
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-3674
Mailing Address - Country:US
Mailing Address - Phone:251-680-2183
Mailing Address - Fax:
Practice Address - Street 1:4565 WOODWIND DR
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-3674
Practice Address - Country:US
Practice Address - Phone:251-680-2183
Practice Address - Fax:251-680-2183
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARRTP-015856367500000X
FL9424767367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered