Individual
PROF. MAVIS THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708
(757) 953-5008
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2197
(757) 953-8959
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0024170372
VA
Other
Enumeration date
10/30/2012
Last updated
12/15/2014
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