Provider Demographics
NPI:1356706568
Name:THOMAS, ANDREA RENEE (RN, APRN)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RENEE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:R
Other - Last Name:RICHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256 CENTRAL CREDENTIALING
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-585-5505
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-475-8990
Practice Address - Fax:513-472-7243
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN CNP 019878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily