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General NPI Number Information
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NPI Number | 1245039189
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Entity Type | Organization
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Legal Business Name | KC THOMAS PSYCHIATRY SERVICES LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 5920 COLISEUM BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3714
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Country | US
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Telephone | 337-852-9285
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Fax |
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Provider Business Mailing Address
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Address Line | 626 BROAD ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-4337
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Country | US
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Telephone | 337-852-9285
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KRISTINA CHRISTOPHE THOMAS
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Credential | APRN, PMHNP
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Telephone | 337-852-9285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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