Individual
MARY L THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 335-4070
Mailing address
2317 MYRTLE ST, ALEXANDRIA, LA 71301-5150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07124
LA
363LF0000X
Family Nurse Practitioner
AP07124
LA
Other
Enumeration date
11/02/2015
Last updated
09/28/2023
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