Healthcare Provider Details

I. General information

NPI: 1154787638
Provider Name (Legal Business Name): ALICIA R THOMAS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALICIA R. CLIMER

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 E SUNSHINE ST
SPRINGFIELD MO
65804-1815
US

IV. Provider business mailing address

2040 E SUNSHINE ST
SPRINGFIELD MO
65804-1815
US

V. Phone/Fax

Practice location:
  • Phone: 417-275-8900
  • Fax: 417-270-8012
Mailing address:
  • Phone: 417-275-8900
  • Fax: 417-270-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015041113
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2015041113
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: