| Doctor Name: | MRS. KATHLEEN ANN THOM |
| NPI Number: | 1033574108 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 117115-30 |
| Business Practice Address: | 702 N. Front Street Spooner, WI - 54871 |
| Business Phone Number: | 7156353539 |
| Business Fax Number: | 7156353086 |
| Mailing Address: | 16757 W. County Road Dd, BIRCHWOOD |
| State: | WI |
| Postal Code: | 548179151 |
| Phone Number: | 7152960114 |
| Fax Number: | |
| NPI Enumeration Date: | 12/16/2015 |
| NPI Last Update Date: | 12/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 117115-30 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |