Provider Demographics
NPI:1730240656
Name:STRICKLAND, THOMAS EARL SR (RN-CS, FNP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EARL
Last Name:STRICKLAND
Suffix:SR
Gender:M
Credentials:RN-CS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 OLD NORCROSS RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4386
Mailing Address - Country:US
Mailing Address - Phone:770-339-1387
Mailing Address - Fax:770-962-7868
Practice Address - Street 1:771 OLD NORCROSS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4980
Practice Address - Country:US
Practice Address - Phone:770-339-1387
Practice Address - Fax:770-339-1387
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN064327363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA085000891GMedicaid
GA00498352AMedicaid
GA00498352BMedicaid
GAS70211Medicare UPIN