Provider Demographics
NPI:1871274845
Name:THOMAS, MARQUITA (APRN)
Entity type:Individual
Prefix:
First Name:MARQUITA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14892 N US HIGHWAY 25 E STE 11
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-6190
Mailing Address - Country:US
Mailing Address - Phone:606-727-2690
Mailing Address - Fax:606-727-2699
Practice Address - Street 1:14892 N US HIGHWAY 25 E STE 11
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-6190
Practice Address - Country:US
Practice Address - Phone:606-727-2690
Practice Address - Fax:606-727-2699
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY4007360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily