Provider Demographics
NPI:1871231902
Name:ANSELL, THOMAS WILLIAM (FNP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WILLIAM
Last Name:ANSELL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CLIFF MINE ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275
Mailing Address - Country:US
Mailing Address - Phone:878-201-3312
Mailing Address - Fax:878-201-3584
Practice Address - Street 1:200 CLIFF MINE ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275
Practice Address - Country:US
Practice Address - Phone:878-201-3312
Practice Address - Fax:878-201-3584
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA532231163W00000X
PASP025795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse