Basic Information
| Provider Information | |||||||||
| NPI: | 1023087798 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | TERRY | ||||||||
| MiddleName: | SHANNON | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA, APRN ,BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1928 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685024825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5759211371 | ||||||||
| FaxNumber: | 4024724593 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 U STREET | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685880618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024727484 | ||||||||
| FaxNumber: | 4024724593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 10/15/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 110818 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.