Provider Demographics
NPI:1912081381
Name:THOMAS, DEBORAH ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E BURWELL AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5007
Mailing Address - Country:US
Mailing Address - Phone:865-546-1433
Mailing Address - Fax:865-546-1433
Practice Address - Street 1:428 E BURWELL AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-5007
Practice Address - Country:US
Practice Address - Phone:865-546-1433
Practice Address - Fax:865-546-1433
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN656500OtherCOMBINED INS
TN656500OtherBANKERS LIFE AND CASUALTY
TN20265138037939A001OtherTRICARE
TN7102000TN37939OtherBCBS MI
TN3729944Medicaid
TN4133158OtherBCBS TN GROUP
TN656500OtherBANKERS LIFE AND CASUALTY
TN3729944Medicare ID - Type UnspecifiedGROUP NUMBER
TN7102000TN37939OtherBCBS MI
TNP88995Medicare UPIN