MEDICARE: FELICIA THOMAS

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	363L00000X	Nurse Practitioner	APRN11003896	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104474758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA THOMAS

Provider Business Mailing Address
First Line	:	813 LINDSEY PL
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-3576
Country	:	US
Telephone Number	:	863-348-0997
Fax Number	:	863-474-0777

Provider Business Practice Location Address
First Line	:	813 LINDSEY PL
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-3576
Country	:	US
Telephone Number	:	873-605-8509
Fax Number	:

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

Provider Enumeration Date	:	08/27/2019
Last Update Date	:	06/17/2026

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Directions to “ FELICIA THOMAS ” Practice Location

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