Provider Demographics
NPI:1235107848
Name:THOMAS, CHRISTINE L (PA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0040
Mailing Address - Country:US
Mailing Address - Phone:207-498-2359
Mailing Address - Fax:207-498-3947
Practice Address - Street 1:SIGRID E TOMPKINS HEALTH CENTER
Practice Address - Street 2:22 HARTFORD ST
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1891
Practice Address - Country:US
Practice Address - Phone:207-532-4068
Practice Address - Fax:207-764-0629
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPA608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES68575Medicare UPIN