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Individual
DESTIN THOMAS
Active
Individual
DESTIN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201805
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5017612
NC
Other
Enumeration date
04/21/2020
Last updated
06/03/2025
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