Provider Demographics
NPI:1518299981
Name:THOMAS, RENU ALEX (MA)
Entity Type:Individual
Prefix:
First Name:RENU
Middle Name:ALEX
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 VINE ST
Mailing Address - Street 2:APT 5
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2223 VINE ST
Practice Address - Street 2:APT 5
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-2456
Practice Address - Country:US
Practice Address - Phone:480-225-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program