Provider Demographics
NPI:1851071161
Name:THOMAS, KATRESE L (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KATRESE
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:KATRESE
Other - Middle Name:L
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 E HANNA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2702
Mailing Address - Country:US
Mailing Address - Phone:302-983-1279
Mailing Address - Fax:
Practice Address - Street 1:240 N JAMES ST STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3171
Practice Address - Country:US
Practice Address - Phone:302-543-4425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010475363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health