Healthcare Provider Details

I. General information

NPI: 1821782004
Provider Name (Legal Business Name): CHRISTINA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ARLINGTON ST UNIT 38
AKRON OH
44306-3771
US

IV. Provider business mailing address

PO BOX 933132
CLEVELAND OH
44193-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-975-9188
  • Fax: 330-564-9977
Mailing address:
  • Phone: 888-975-9188
  • Fax: 330-564-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0034243
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.319562
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: