Provider Demographics
NPI:1427474600
Name:THOMAS, ANGELA MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MICHELLE
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 1:1825 SONOMA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2519
Mailing Address - Country:US
Mailing Address - Phone:530-243-8667
Mailing Address - Fax:
Practice Address - Street 1:1825 SONOMA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2519
Practice Address - Country:US
Practice Address - Phone:530-243-8667
Practice Address - Fax:530-243-8742
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60447552363LF0000X
CANP95003967363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily