Provider Demographics
NPI:1891134482
Name:THOMAS, KAREN (CMA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 NADIES CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-1052
Mailing Address - Country:US
Mailing Address - Phone:317-408-1478
Mailing Address - Fax:
Practice Address - Street 1:301 MCCULLOUGH DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3310
Practice Address - Country:US
Practice Address - Phone:704-559-9408
Practice Address - Fax:704-731-0975
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC$$$$$$$$$Medicaid