Individual
MRS. JACQUELINE FRANCINE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Mailing address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1057416
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MAIN GROUP MEDICARE PAYEE NUMBER
AL
01
—
1063439065
MAIN GROUP NPI PAYEE NUMBER
AL
01
—
51037809
BLUE CROSS BLUE SHIELD
—
05
—
630000013
—
AL
05
—
630101018
—
AL
Enumeration date
07/07/2006
Last updated
09/03/2014
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