Healthcare Provider Details

I. General information

NPI: 1528152311
Provider Name (Legal Business Name): DAWN ASHLEY THOMAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST UNIVERSITY OF KENTUCKY DIVISION OF NEPHROLOGY
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST UNIVERSITY OF KENTUCKY DIVISION OF NEPHROLOGY
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5049
  • Fax:
Mailing address:
  • Phone: 859-323-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3004623
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: