Provider Demographics
NPI:1740596600
Name:THOMAS, ROBIN RENAE (PCA/CNA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENAE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PCA/CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 FAIRFAX AVE
Mailing Address - Street 2:SUITE1
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35020-5268
Mailing Address - Country:US
Mailing Address - Phone:205-337-1479
Mailing Address - Fax:
Practice Address - Street 1:2931 FAIRFAX AVE
Practice Address - Street 2:SUITE1
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-5268
Practice Address - Country:US
Practice Address - Phone:205-337-1479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL372500000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide