Provider Demographics
NPI:1982938627
Name:THOMAS, JEANINE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CNM
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 7242
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-7242
Mailing Address - Country:US
Mailing Address - Phone:340-772-3727
Mailing Address - Fax:340-772-3727
Practice Address - Street 1:#82 MOUNT PLEASANT
Practice Address - Street 2:
Practice Address - City:FREDERICKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-0000
Practice Address - Country:US
Practice Address - Phone:340-772-3727
Practice Address - Fax:340-772-3727
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI4818367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife