Provider Demographics
NPI:1649649229
Name:THOMAS, ANNE ELIZABETH (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19201 E VALLEY VIEW PKWY
Mailing Address - Street 2:STE C
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6913
Mailing Address - Country:US
Mailing Address - Phone:816-317-5070
Mailing Address - Fax:855-862-9292
Practice Address - Street 1:19201 E VALLEY VIEW PKWY STE C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6913
Practice Address - Country:US
Practice Address - Phone:816-317-5070
Practice Address - Fax:855-862-9292
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015032908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGMedicaid
MO132300608Medicare PIN