Provider Demographics
NPI:1669780557
Name:THOMAS, IRYNA (MD, NP)
Entity type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 AURORA CT FL 6
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2541
Mailing Address - Country:US
Mailing Address - Phone:720-848-2659
Mailing Address - Fax:720-848-2651
Practice Address - Street 1:1635 AURORA CT FL 6
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-2650
Practice Address - Fax:720-848-2651
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10369363LF0000X
CO0072629390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96484543Medicaid
COCOA104046Medicare PIN
COP00996388Medicare PIN