Provider Demographics
NPI:1932815479
Name:THOMAS, CATHERINE SHIRLEY (FNP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:SHIRLEY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:S
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:9117 BRIARCHIP ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1303
Mailing Address - Country:US
Mailing Address - Phone:240-491-6622
Mailing Address - Fax:
Practice Address - Street 1:9117 BRIARCHIP ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1303
Practice Address - Country:US
Practice Address - Phone:240-491-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199758163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2022067926OtherANCC - AMERICAN NURSES CREDENTIALING CENTER
MDR199758OtherCRNP NUMBER WITH MARYLAND BOARD OF NURSING