Provider Demographics
NPI:1649687237
Name:THOMAS, LINDA SANDRA (CRNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SANDRA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 MAIN AVE SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-7206
Mailing Address - Country:US
Mailing Address - Phone:256-739-0455
Mailing Address - Fax:256-739-2706
Practice Address - Street 1:1705 MAIN AVE SW
Practice Address - Street 2:SUITE B
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-7206
Practice Address - Country:US
Practice Address - Phone:256-739-0455
Practice Address - Fax:256-739-2706
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily