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NPI 1801102702

NPI 1801102702 : NANCY L THOMAS APN : BRYANT, AR

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General NPI Number Information
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    NPI Number           |    1801102702
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    Entity Type          |    Individual 
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    Provider Name        |    NANCY L THOMAS APN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/30/2010
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    Last Update Date     |    12/03/2012
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Provider Practice Location Address
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    Address Line         |    2301 SPRINGHILL RD STE 200 
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    City                 |    BRYANT
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    State                |    AR
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    Zip                  |    72019-7566
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    Country              |    US
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    Telephone            |    501-315-0078
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    Fax                  |    501-943-3016
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Provider Business Mailing Address
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    Address Line         |    2301 SPRINGHILL RD STE 200 
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    City                 |    BRYANT
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    State                |    AR
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    Zip                  |    72019-7566
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    Country              |    US
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    Telephone            |    501-315-0078
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    Fax                  |    501-943-3016
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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        |    363LP0200X
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    Taxonomy Name        |    Pediatric Nurse Practitioner
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    License Number       |    A01320
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    License Number State |    AR
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