Provider Demographics
NPI:1255484846
Name:THOMAS, JUDITH MARIE (RNBC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RNBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 OLD ROXBURY RD
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1401
Mailing Address - Country:US
Mailing Address - Phone:804-675-5000
Mailing Address - Fax:804-675-5319
Practice Address - Street 1:7009 OLD ROXBURY RD
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1401
Practice Address - Country:US
Practice Address - Phone:804-675-5000
Practice Address - Fax:804-675-5319
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001116427163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse