# JILL M THOMAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124079710
- **Gender:** F
- **Credential:** N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 4704222283 | MI | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 06/15/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 104854881 | — | MI |
| 01 | — | 5008706020 | BLUE CROSS BLUE SHIELD MI | MI |