Healthcare Provider Details

I. General information

NPI: 1467280214
Provider Name (Legal Business Name): CORINNE THOMAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE A LAINO PA-C

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

7101 JAHNKE RD
RICHMOND VA
23225-4017
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-9595
  • Fax: 706-868-8375
Mailing address:
  • Phone: 706-863-9595
  • Fax: 706-868-8375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02989
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011786
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: