Individual
JACQUELINE D THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
Mailing address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP1058812
FL
Other
Enumeration date
07/28/2012
Last updated
01/10/2018
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