Thorn, Marybeth
Thorn, Marybeth is an individual health care provider with primary practice located at 5904 Holly Ave Ne , Albuquerque NM 87113-2472. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Thorn, Marybeth can be contacted via phone (505) 298-2505.Contact Information
Primary practice address
5904 Holly Ave Ne
Albuquerque NM 87113-2472
Phone: (505) 298-2505
Fax: (505) 298-2985
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 244 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 102676 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 86-PA052 | New Mexico |
Profile Details
| NPI number | 1730253063 |
|---|---|
| LBN Legal business name | Thorn, Marybeth |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Apr 7th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730253063 | NPPES |
| Colorado | MEDICAID | 91407770 | |
| Colorado | Other | PA244 | |
| Colorado | Other | 102676 |
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