MEDICARE: FELICIA R 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	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1066071610	OTHER	NV	DRIVERS LICENSR
2	1606071610	OTHER	NV	DRIVERS LICENSE

General Provider Information

NPI Number	:	1528729688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA R THOMAS

Provider Business Mailing Address
First Line	:	5124 PAINTED WOODS CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-2306
Country	:	US
Telephone Number	:	269-830-4458
Fax Number	:

Provider Business Practice Location Address
First Line	:	7629 VALLEY GREEN DR UNIT 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-0350
Country	:	US
Telephone Number	:	702-812-5567
Fax Number	:

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

Provider Enumeration Date	:	12/31/2021
Last Update Date	:	12/31/2021

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Directions to “ FELICIA R THOMAS ” Practice Location

Language	Start Address	Practice Location

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