Individual
JENNIFER ANN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
225 MEDICAL CENTER DR, STE 307, PADUCAH, KY 42003-7914
(270) 441-4700
(270) 441-4707
Mailing address
225 MEDICAL CENTER DRIVE, STE 307, PADUCAH, KY 42003
(270) 441-4700
(270) 441-4707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TR42751
KY
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
3005114
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0392813
GROUP PTAN
KY
01
—
3928
MEDICARE GROUP
KY
01
—
3928
MEDICARE GROUP
—
Enumeration date
08/20/2006
Last updated
07/31/2015
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