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Individual

ANA LYNN THOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9201 BIG HORN BLVD, ELK GROVE, CA 95758-1240
(916) 478-5786
Mailing address
8010 COBBLE CT, GRANITE BAY, CA 95746-9024
(909) 718-9873

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
574907
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
574907
REGISTERED NURSE
CA
Enumeration date
10/25/2022
Last updated
10/25/2022
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