Provider Demographics
NPI:1750356697
Name:THOMAS, DONNA (CFNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702
Mailing Address - Country:US
Mailing Address - Phone:606-439-1300
Mailing Address - Fax:606-439-1400
Practice Address - Street 1:145 CITIZENS LANE
Practice Address - Street 2:SUITE B PRIMARY CARE CENTERS OF EASTERN KENTUCKY
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701
Practice Address - Country:US
Practice Address - Phone:606-439-1300
Practice Address - Fax:606-439-1400
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2504P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78002136Medicaid
KYS45624Medicare UPIN
KY183947Medicare Oscar/Certification
KY183918Medicare Oscar/Certification
KY0776305Medicare PIN
KY00051001Medicare PIN