Provider Demographics
NPI:1083819296
Name:THOMAS, VIRGINIA R (PA-C)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1499 W 120TH AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2751
Mailing Address - Country:US
Mailing Address - Phone:303-920-5161
Mailing Address - Fax:303-452-4625
Practice Address - Street 1:1499 W 120TH AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2751
Practice Address - Country:US
Practice Address - Phone:303-920-5161
Practice Address - Fax:303-452-4625
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO27368164W00000X
CO2895363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No164W00000XNursing Service ProvidersLicensed Practical Nurse