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General NPI Number Information
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NPI Number | 1407476336
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Entity Type | Individual
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Provider Name | DESTIN THOMAS PMHNP
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 154 MEDICAL PARK LOOP
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City | SYLVA
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State | NC
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Zip | 28779-5271
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Country | US
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Telephone | 828-307-0900
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Fax | 866-340-6013
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Provider Business Mailing Address
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Address Line | 141 SIMS CIR
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City | WAYNESVILLE
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State | NC
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Zip | 28786-3035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5017612
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201805
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License Number State | LA
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