Healthcare Provider Details

I. General information

NPI: 1275147563
Provider Name (Legal Business Name): ASHLEY LYNNE THOMAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N KEENE ST STE 301
COLUMBIA MO
65201-8053
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8000
  • Fax: 573-882-6600
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020028343
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: