Provider Demographics
NPI:1487086310
Name:THOMAS, PRABHA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:PRABHA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:PRABHA
Other - Middle Name:
Other - Last Name:SAMUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-7037
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD STE 403
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-710-4460
Practice Address - Fax:215-710-4465
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily