Provider Demographics
NPI:1891233862
Name:THOMAS, ELIZABETH (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 RIVERFRONT PKWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2233
Mailing Address - Country:US
Mailing Address - Phone:423-634-3124
Mailing Address - Fax:423-634-1003
Practice Address - Street 1:1301 RIVERFRONT PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2233
Practice Address - Country:US
Practice Address - Phone:423-634-3124
Practice Address - Fax:423-634-1003
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN220298163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health