Provider Demographics
NPI:1467519124
Name:THOMAS, CHRISTINE LUVENIA (MS, RNC, FNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LUVENIA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, RNC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W LEWISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-9326
Mailing Address - Country:US
Mailing Address - Phone:252-398-3759
Mailing Address - Fax:
Practice Address - Street 1:208 DUNDEE ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-6701
Practice Address - Country:US
Practice Address - Phone:252-209-8932
Practice Address - Fax:252-209-8933
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200873363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS47111Medicare UPIN