Provider Demographics
NPI:1396034252
Name:THOMAS, KAREN A (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 E CHAUTAUQUA ST
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14757-1005
Mailing Address - Country:US
Mailing Address - Phone:716-269-2034
Mailing Address - Fax:
Practice Address - Street 1:64 E CHAUTAUQUA ST
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:14757-1005
Practice Address - Country:US
Practice Address - Phone:716-269-2034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302942164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse