Basic Information
| Provider Information | |||||||||
| NPI: | 1568979292 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | SANTANNA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 545 ELDER ST | ||||||||
| Address2: | |||||||||
| City: | IRONDALE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352103303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2566037136 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2807 GREYSTONE COMMERCIAL BLVD | ||||||||
| Address2: | UNIT 38 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352429601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059951009 | ||||||||
| FaxNumber: | 2059951049 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2018 | ||||||||
| LastUpdateDate: | 09/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 1-148355 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.