Provider Demographics
NPI:1063859411
Name:THOMAS, KAREN DEVINCENT (ANP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DEVINCENT
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ANP
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Mailing Address - Street 1:4921 PARKVIEW PL
Mailing Address - Street 2:SHOENBERG BUILDING-FIRST FLOOR
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1032
Mailing Address - Country:US
Mailing Address - Phone:314-454-8134
Mailing Address - Fax:314-454-8063
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:SHOENBERG BUILDING-FIRST FLOOR
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-8134
Practice Address - Fax:314-454-8063
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO149340363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health