Individual
DERRICK DON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3205 N TWYMAN RD, INDEPENDENCE, MO 64058-3212
(816) 750-1813
Mailing address
5500 MING AVE STE 265, BAKERSFIELD, CA 93309-4696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2024004445
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2024004445
LISCENSE
MO
Enumeration date
03/28/2025
Last updated
03/28/2025
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