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1013235902

NPI Code Detail

MEDICARE: JENNIFER ANN THOMAS NP

MEDICARE: JENNIFER ANN THOMAS NP

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
1	163W00000X	Registered Nurse	0001205407	VA
2	363LW0102X	Women's Health Nurse Practitioner	0024168723	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	-010	OTHER	VA	TRICARE/CHAMPUS
2	PAR	OTHER	VA	MULTIPLAN
3	PAR	OTHER	VA	CORVEL
4	PAR	OTHER	VA	USA MANAGED CARE
5	10086920N	OTHER	VA	OPTIMA HEALTH
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	1013235902	OTHER	VA	VIRGINIA PREMIER HEALTH PLAN
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013235902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN THOMAS NP

Provider Business Mailing Address
First Line	:	112 MAVERICK CT
Second Line	:
City	:	GRANBURY
State	:	TX
Zip	:	76049-1381
Country	:	US
Telephone Number	:	888-731-8994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 WILSON BLVD FL 6
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22209-2281
Country	:	US
Telephone Number	:	888-731-8994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2010
Last Update Date	:	02/27/2025

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Directions to “ JENNIFER ANN THOMAS NP” Practice Location

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