MEDICARE: DR. KATHRYN JANE THOMAS APRN, PHD

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	101Y00000X	Counselor	RO66486	MD
2	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	R066486	MD

General Provider Information

NPI Number	:	1598927964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN JANE THOMAS APRN, PHD

Provider Business Mailing Address
First Line	:	2360 W JOPPA RD
Second Line	:	SUITE 219
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-4624
Country	:	US
Telephone Number	:	410-616-7152
Fax Number	:

Provider Business Practice Location Address
First Line	:	2360 W JOPPA RD
Second Line	:	SUITE 219
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-4624
Country	:	US
Telephone Number	:	410-616-7152
Fax Number	:

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

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	05/02/2023

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