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Individual

MRS. SYLVIA GRACE THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
3400 W TRUMAN BLVD, JEFFERSON CITY, MO 65109-5712
(573) 632-2777
(573) 632-2769
Mailing address
3349 AMERICAN AVE STE C, JEFFERSON CITY, MO 65109-1080
(573) 632-2777
(573) 632-2769

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
NOT YET AVAILABLE
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
120727
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346484011
MO
Enumeration date
04/26/2009
Last updated
03/01/2011
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