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NPI Code Detail

MEDICARE: NICOLE THOMAS APRN

MEDICARE: NICOLE THOMAS APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP 9181882FL

General Provider Information

NPI Number : 1003065509
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE THOMAS APRN
Provider Business Mailing Address
First Line : 1891 BEACH BLVD
Second Line : SUITE 200
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-2644
Country : US
Telephone Number : 904-249-3743
Fax Number : 904-249-2047
Provider Business Practice Location Address
First Line : 1891 BEACH BLVD
Second Line : SUITE 200
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-2644
Country : US
Telephone Number : 904-249-3743
Fax Number : 904-249-2047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2008
Last Update Date : 04/13/2022

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1144657263 — SHERRI K JACKSON APRN
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Directions to “ NICOLE THOMAS APRN” Practice Location

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