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NPI Code Detail

MEDICARE: NIRMALA THOMAS CRNP

MEDICARE: NIRMALA 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
1363LP2300XPrimary Care Nurse PractitionerR156644MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NONEOTHERN/A

General Provider Information

NPI Number : 1639651680
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIRMALA THOMAS CRNP
Provider Business Mailing Address
First Line : 8316 CANYON OAK DR
Second Line :
City : SEVERN
State : MD
Zip : 21144-6811
Country : US
Telephone Number : 240-463-0239
Fax Number :
Provider Business Practice Location Address
First Line : 2131 DAVIDSONVILLE RD
Second Line :
City : CROFTON
State : MD
Zip : 21114-1632
Country : US
Telephone Number : 410-507-7617
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2018
Last Update Date : 08/08/2022

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