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NPI Code Detail

MEDICARE: MS. JUSTINE THOMAS R.N.

MEDICARE: MS. JUSTINE THOMAS R.N.
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
1163W00000XRegistered Nurse4704303747MI

General Provider Information

NPI Number : 1326421579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUSTINE THOMAS R.N.
Provider Business Mailing Address
First Line : 2280 CESSNA DR
Second Line :
City : TWIN LAKE
State : MI
Zip : 49457-8989
Country : US
Telephone Number : 231-724-3602
Fax Number : 231-724-3327
Provider Business Practice Location Address
First Line : 2280 CESSNA DR
Second Line :
City : TWIN LAKE
State : MI
Zip : 49457-8989
Country : US
Telephone Number : 231-724-3602
Fax Number : 231-724-3327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 07/07/2015

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Directions to “ MS. JUSTINE THOMAS R.N.” Practice Location

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