Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACQULYN RENA THOMAS
ActiveUrology Nurse · FORT WAYNE, IN
Registration Details
- NPI Number
- 1316648355
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 16, 2023 (3.1034119244806 yrs)
- Last Updated
- Mar 16, 2023
- License
-
28149682A (IN)
Practice Information
- Address
-
2121 LAKE AVEFORT WAYNE, IN, 468055100Browse IN providers · Browse ZIP 46805
- Phone
- 2604265431
- Fax
- 2604601385
- Primary Specialty
-
Urology Nurse
163WU0100X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.