Basic Information
Provider Information
NPI: 1396315271
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMAS
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 12248
Address2:  
City: NEW BERN
State: NC
PostalCode: 285612248
CountryCode: US
TelephoneNumber: 2526335333
FaxNumber: 2526339443
Practice Location
Address1: 702 NEWMAN RD
Address2:  
City: NEW BERN
State: NC
PostalCode: 285625238
CountryCode: US
TelephoneNumber: 2526335333
FaxNumber: 2526339443
Other Information
ProviderEnumerationDate: 07/01/2021
LastUpdateDate: 02/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5014925NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home