Provider Demographics
NPI:1528367927
Name:THOMAS, KRISTY LEIGH (DPH)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LEIGH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5921 MANOR PL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4432
Mailing Address - Country:US
Mailing Address - Phone:615-377-0522
Mailing Address - Fax:
Practice Address - Street 1:5713 EDMONDSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-6216
Practice Address - Country:US
Practice Address - Phone:615-315-9459
Practice Address - Fax:615-332-0382
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC-6567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist