Provider Demographics
NPI:1689299224
Name:THOMAS, CHRISHAWN L
Entity Type:Individual
Prefix:
First Name:CHRISHAWN
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 MCLEOD DR STE 25
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4075
Mailing Address - Country:US
Mailing Address - Phone:702-336-6362
Mailing Address - Fax:855-469-3831
Practice Address - Street 1:6255 MCLEOD DR STE 25
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4075
Practice Address - Country:US
Practice Address - Phone:702-336-6362
Practice Address - Fax:855-469-3831
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker