Provider Demographics
NPI:1588048086
Name:THOMAS, MARYANN DAWN (ARNP)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:DAWN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 BROADWAY PH 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2614
Mailing Address - Country:US
Mailing Address - Phone:347-294-3414
Mailing Address - Fax:
Practice Address - Street 1:1 HAWTHORNE ST UNIT 23D
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3984
Practice Address - Country:US
Practice Address - Phone:347-943-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPRN-LIC-261868363LF0000X
NC5017280363LF0000X
MDAC006384363LF0000X
WAAP60578104363LF0000X
NV886233363LF0000X
NM79969363LF0000X
AZ322468363LF0000X
ID5371655363LF0000X
CA95024943363LF0000X
AK234076363LF0000X
COC-APN.0103976363LF0000X
HIAPRN-5146363LF0000X
TX1098426363L00000X
OR10039355363LF0000X
FLAPRN11024135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner