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NPI Code Detail

MEDICARE: KATHLEEN THOMAS FNP-C

MEDICARE: KATHLEEN THOMAS FNP-C
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
1173000000XLegal Medicine216373-4405UT
2207Q00000XFamily Medicine Physician216373-4405UT

General Provider Information

NPI Number : 1740235290
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN THOMAS FNP-C
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 435-649-7640
Fax Number :
Provider Business Practice Location Address
First Line : 1665 BONANZA DR
Second Line :
City : PARK CITY
State : UT
Zip : 84060-5127
Country : US
Telephone Number : 435-649-7640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 01/25/2013

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Directions to “ KATHLEEN THOMAS FNP-C” Practice Location

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