Individual
VENYETTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
896 HIGHWAY 81 E, MCDONOUGH, GA 30252-2914
(404) 948-3019
Mailing address
6381 ZEBULON RD, MACON, GA 31220-2601
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN192517
GA
363LF0000X
Family Nurse Practitioner
RN192517
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136324C
—
GA
05
—
003136324D
—
GA
Enumeration date
06/15/2012
Last updated
10/18/2021
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