Individual
JENNIFER RENEE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
13 MEDICAL CAMPUS DR NW STE 102, SUPPLY, NC 28462-4093
(910) 754-5988
(910) 754-5989
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011501
NC
363LF0000X
Family Nurse Practitioner
5011501
NC
Other
Enumeration date
02/22/2019
Last updated
12/28/2022
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