MEDICARE: CAROL 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	363L00000X	Nurse Practitioner	027409222	MO

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	:	1386641843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL THOMAS NP

Provider Business Mailing Address
First Line	:	PO BOX 1341
Second Line	:
City	:	PLATTE CITY
State	:	MO
Zip	:	64079-1341
Country	:	US
Telephone Number	:	816-858-4600
Fax Number	:	816-858-9900

Provider Business Practice Location Address
First Line	:	700 BRANCH ST.
Second Line	:	SUITE 1
City	:	PLATTE CITY
State	:	MO
Zip	:	64079-1341
Country	:	US
Telephone Number	:	816-858-4600
Fax Number	:	816-858-9900

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/31/2011

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Directions to “ CAROL THOMAS NP” Practice Location

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