Provider Demographics
NPI:1902301435
Name:THANKAPPAN, JOBY T (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JOBY
Middle Name:T
Last Name:THANKAPPAN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:MRS
Other - First Name:JOBY
Other - Middle Name:T
Other - Last Name:THANKAPPAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JOBY THANKAPPAN
Mailing Address - Street 1:559 E OVILLA RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3505
Mailing Address - Country:US
Mailing Address - Phone:855-955-2256
Mailing Address - Fax:817-533-6015
Practice Address - Street 1:1441 N BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-947-5000
Practice Address - Fax:214-947-5040
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily