Individual
MS. CERETHA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
139 HENRY PKWY, MCDONOUGH, GA 30253
(770) 358-5252
Mailing address
1464 INDIAN FOREST CT, STONE MOUNTAIN, GA 30083-5436
(404) 740-2870
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
211903NP
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211903
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104504G
—
GA
Enumeration date
06/13/2006
Last updated
06/17/2022
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