Basic Information
| Provider Information | |||||||||
| NPI: | 1699915744 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 714328 | ||||||||
| Address2: | SUITE 10 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432714328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403520400 | ||||||||
| FaxNumber: | 4403524535 | ||||||||
| Practice Location | |||||||||
| Address1: | 7580 AUBURN ROAD | ||||||||
| Address2: | |||||||||
| City: | CONCORD TOWNSHIP | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440770000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403520400 | ||||||||
| FaxNumber: | 4403524535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2009 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 10423 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 217498 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.