Individual
JENNIFA K THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3500 FRANCISCAN WAY STE 300, MICHIGAN CITY, IN 46360-0033
(219) 879-6531
(219) 878-8331
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28137882A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201090650
—
IN
Enumeration date
07/05/2012
Last updated
06/20/2024
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