Provider Demographics
NPI:1497116610
Name:THOMAS, PATRICIA ANN
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1024 RIVER VALLEY DR
Mailing Address - Street 2:APT. 1040
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2920
Mailing Address - Country:US
Mailing Address - Phone:810-820-7071
Mailing Address - Fax:
Practice Address - Street 1:1024 RIVER VALLEY DR
Practice Address - Street 2:APT. 1040
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-2920
Practice Address - Country:US
Practice Address - Phone:810-820-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703039628164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse