Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0024168723 | VA |
NPI | 1013235902 |
---|---|
Provider Name | Jennifer Ann Thomas |
First Address | Norfolk, VA 23501-0936 |
Second Address | Norfolk, VA 23507-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2010 |
Last Update Date | 26/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
-010 | TRICARE/CHAMPUS (01) | VA |
10086920N | OPTIMA HEALTH (01) | VA |
1013235902 | (05) | VA |
1013235902 | VIRGINIA PREMIER HEALTH PLAN (01) | VA |
7005854 | (05) | NC |
PAR | CORVEL (01) | VA |
PAR | MULTIPLAN (01) | VA |
PAR | USA MANAGED CARE (01) | VA |