Healthcare Provider Details

I. General information

NPI: 1891651642
Provider Name (Legal Business Name): BLESSY THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 S ROME ST
GILBERT AZ
85297-7361
US

IV. Provider business mailing address

1133 S NIELSON ST
GILBERT AZ
85296-3672
US

V. Phone/Fax

Practice location:
  • Phone: 480-667-5500
  • Fax:
Mailing address:
  • Phone: 480-353-8504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number333241
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: