MEDICARE: CHRISTINA THOMAS CRNP

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	207Q00000X	Family Medicine Physician	SP020672	PA

General Provider Information

NPI Number	:	1386288710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA THOMAS CRNP

Provider Business Mailing Address
First Line	:	7301 WEST BLVD STE A1
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-5268
Country	:	US
Telephone Number	:	330-758-2775
Fax Number	:	330-758-2787

Provider Business Practice Location Address
First Line	:	3548 ELLWOOD RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-6122
Country	:	US
Telephone Number	:	724-658-9477
Fax Number	:	724-658-9476

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

Provider Enumeration Date	:	10/29/2019
Last Update Date	:	12/11/2019

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