Provider Demographics
NPI:1679131031
Name:THOMAS, JANEA A (APRN)
Entity type:Individual
Prefix:
First Name:JANEA
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANEA
Other - Middle Name:A
Other - Last Name:THALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:507 FOOTHILLS PLZ
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-2312
Mailing Address - Country:US
Mailing Address - Phone:865-238-7450
Mailing Address - Fax:
Practice Address - Street 1:507 FOOTHILLS PLZ
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-2312
Practice Address - Country:US
Practice Address - Phone:865-238-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002742363L00000X
TN34837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner