Basic Information
| Provider Information | |||||||||
| NPI: | 1366829327 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THUMAN | ||||||||
| FirstName: | ASHLIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2315 MYRTLE ST | ||||||||
| Address2: | SUITE 190 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165024604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144537767 | ||||||||
| FaxNumber: | 8144546667 | ||||||||
| Practice Location | |||||||||
| Address1: | 2315 MYRTLE ST | ||||||||
| Address2: | SUITE 190 | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165024604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144537767 | ||||||||
| FaxNumber: | 8144546667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2015 | ||||||||
| LastUpdateDate: | 08/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP014945 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | SP014945 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163W00000X | RN669270 | PA | N | Nursing Service Providers | Registered Nurse |
No ID Information.