Provider Demographics
NPI:1093738734
Name:THOMAS, VIRGINIA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 AVENUE F ENSLEY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35218-1638
Mailing Address - Country:US
Mailing Address - Phone:205-785-7337
Mailing Address - Fax:205-788-4767
Practice Address - Street 1:2010 AVENUE F
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35218-1638
Practice Address - Country:US
Practice Address - Phone:205-785-7337
Practice Address - Fax:205-788-4767
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-032293363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP47298Medicare UPIN
AL051551410Medicare ID - Type Unspecified