Healthcare Provider Details

I. General information

NPI: 1265663512
Provider Name (Legal Business Name): JENNIFER M THOMAS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 N 1ST ST
DENNISON OH
44621-1003
US

IV. Provider business mailing address

2438 STATE ROUTE 39 NE
NEW PHILADELPHIA OH
44663-8095
US

V. Phone/Fax

Practice location:
  • Phone: 740-922-0000
  • Fax:
Mailing address:
  • Phone: 740-922-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN-292576
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: