Healthcare Provider Details

I. General information

NPI: 1285396341
Provider Name (Legal Business Name): SKYE NICOLE THOMAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SKYE NICOLE CHRISTIAN PA-C

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N 21ST ST
CAMP HILL PA
17011-2204
US

IV. Provider business mailing address

4 SILK MILL DR APT 436
EAST PENNSBORO PA
17025-2492
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-2100
  • Fax:
Mailing address:
  • Phone: 717-743-6313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberOA005765
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA062686
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA005765
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA062686
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: