Provider Demographics
NPI:1326318171
Name:THOMS, JEANETTE A
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:A
Last Name:THOMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 6TH ST NE
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3220
Mailing Address - Country:US
Mailing Address - Phone:319-360-9623
Mailing Address - Fax:
Practice Address - Street 1:180 10TH ST SE
Practice Address - Street 2:SUITE 201
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-2559
Practice Address - Country:US
Practice Address - Phone:712-546-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator