Healthcare Provider Details

I. General information

NPI: 1386734085
Provider Name (Legal Business Name): DEBORAH ANN THOMAS RN,MS,AOCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 3RD ST
DAYTON OH
45428-9000
US

IV. Provider business mailing address

214 SHELFORD WAY
DAYTON OH
45440-3662
US

V. Phone/Fax

Practice location:
  • Phone: 937-262-5987
  • Fax: 937-267-5313
Mailing address:
  • Phone: 937-262-5987
  • Fax: 937-267-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number232299/NS04223
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: