Individual
BRENNA M THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1310 ENGLE CT, O'FALLON, IL 62269
(618) 581-2854
Mailing address
1310 ENGLE CT, O FALLON, IL 62269-6722
(618) 581-2854
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041400301
IL
163WC0200X
Critical Care Medicine Registered Nurse
2009022776
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2018024574
MO
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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