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General NPI Number Information
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NPI Number | 1821150426
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Entity Type | Individual
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Provider Name | KATHALEEN L THOMAS FNP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 60205 BODNAR BLVD
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City | MISHAWAKA
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State | IN
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Zip | 46544-9342
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Country | US
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Telephone | 574-345-0246
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Fax | 574-381-5740
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Provider Business Mailing Address
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Address Line | 350 COMMERCE SQ
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-3376
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Country | US
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Telephone | 219-872-9158
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28127434A
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License Number State | IN
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