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General NPI Number Information
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NPI Number | 1497643746
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Entity Type | Individual
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Provider Name | CODI JO THOMAS NP
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2900 LAMB CIRICLE STE 201
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City | CHRISTANSBURG
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State | VA
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Zip | 24073
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Country | US
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Telephone | 540-731-2328
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 0001282569
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024194092
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License Number State | VA
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