Provider Demographics
NPI:1609632611
Name:THOMAS, KIMBERLY (RD, LD, CNSC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RD, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WENTWORTH DOUGLASS HOSPITAL
Mailing Address - Street 2:789 CENTRAL AVE
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820
Mailing Address - Country:US
Mailing Address - Phone:603-742-5252
Mailing Address - Fax:
Practice Address - Street 1:MASS GENERAL CANCER CENTER
Practice Address - Street 2:100 CORPORATE DRIVE, BLDG C
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-609-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0807133VN1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology