Provider Demographics
NPI:1881269009
Name:OHARRA, THOMAS FRANKLIN (RN)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FRANKLIN
Last Name:OHARRA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45216
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-5216
Mailing Address - Country:US
Mailing Address - Phone:505-350-2638
Mailing Address - Fax:
Practice Address - Street 1:12452 TOWNER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-3660
Practice Address - Country:US
Practice Address - Phone:505-350-2638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR35834163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty