MEDICARE: GENEVIEVE C THOMAS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	229581	TX

General Provider Information

NPI Number	:	1427008218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENEVIEVE C THOMAS CRNA

Provider Business Mailing Address
First Line	:	420 WATER ST
Second Line	:	#105-B
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5200
Country	:	US
Telephone Number	:	830-896-1344
Fax Number	:	830-896-1363

Provider Business Practice Location Address
First Line	:	420 WATER ST
Second Line	:	#105-B
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5200
Country	:	US
Telephone Number	:	830-896-1344
Fax Number	:	830-896-1363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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