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NPI Code Detail

MEDICARE: MARY SUSAN THOMAS NP

MEDICARE: MARY SUSAN 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
1363LF0000XFamily Nurse Practitioner04382LA

General Provider Information

NPI Number : 1437305208
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY SUSAN THOMAS NP
Provider Business Mailing Address
First Line : 6400 PERKINS RD
Second Line : INPATIENT UNIT
City : BATON ROUGE
State : LA
Zip : 70808-4124
Country : US
Telephone Number : 225-763-2678
Fax Number :
Provider Business Practice Location Address
First Line : 6400 PERKINS RD
Second Line : INPATIENT UNIT
City : BATON ROUGE
State : LA
Zip : 70808-4124
Country : US
Telephone Number : 225-763-2678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2008
Last Update Date : 01/21/2010

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