Basic Information
| Provider Information | |||||||||
| NPI: | 1235434739 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2080 W ARLINGTON BLVD STE B | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278343770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527522140 | ||||||||
| FaxNumber: | 2526896502 | ||||||||
| Practice Location | |||||||||
| Address1: | 2607 MEDICAL OFFICE PL | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275349437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193301941 | ||||||||
| FaxNumber: | 8555404722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2011 | ||||||||
| LastUpdateDate: | 11/07/2018 | ||||||||
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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 | 208VP0000X | 194558 | NC | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 363L00000X | 5004732 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2200X | 5004732 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.