Provider Demographics
NPI:1073821021
Name:THOMAS, QUIANA C (STNA)
Entity Type:Individual
Prefix:MS
First Name:QUIANA
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 LOGANBERRY DR
Mailing Address - Street 2:#107
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1108
Mailing Address - Country:US
Mailing Address - Phone:216-882-7299
Mailing Address - Fax:
Practice Address - Street 1:26700 LLOGANBERRY DR.
Practice Address - Street 2:#107
Practice Address - City:RICHMOND HTS.
Practice Address - State:OH
Practice Address - Zip Code:44903-6706
Practice Address - Country:US
Practice Address - Phone:216-882-7299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400961680809376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide