Individual
JEANNETTE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2790 CLAY EDWARDS DR, SUITE 520, NORTH KANSAS CITY, MO 64116-3276
(816) 221-6750
Mailing address
9411 N OAK TRFY, SUITE LL1, KANSAS CITY, MO 64155-2233
(816) 436-7072
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2005001743
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35183021
BCBS KC INDIV #
MO
Enumeration date
07/27/2006
Last updated
04/04/2008
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