Provider Demographics
NPI:1801174396
Name:THOMAS, JENNIFER ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8515 GREENVILLE AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7011
Mailing Address - Country:US
Mailing Address - Phone:214-221-0855
Mailing Address - Fax:214-710-1303
Practice Address - Street 1:8515 GREENVILLE AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7011
Practice Address - Country:US
Practice Address - Phone:214-221-0855
Practice Address - Fax:214-710-1303
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX743622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner