Individual
DEJAVAUGHN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3714 PARVISS ST, PITTSBURGH, PA 15212-1944
(412) 636-7441
Mailing address
3714 PARVISS ST, PITTSBURGH, PA 15212-1944
(412) 636-7441
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN710172
PA
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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