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NPI Code Detail

MEDICARE: MR. RODNEY LEE THOMAS JR. APRN, PMHNP-BC

MEDICARE: MR. RODNEY LEE THOMAS JR. APRN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner851389NV

General Provider Information

NPI Number : 1780339887
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RODNEY LEE THOMAS JR. APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 3247 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-2412
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3247 S MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-2412
Country : US
Telephone Number : 877-663-7976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2022
Last Update Date : 02/16/2022

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