| Doctor Name: | MS. JACQUE ANNE THOMAS |
| NPI Number: | 1851712426 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP013099 |
| Business Practice Address: | 529 Hillside Dr Hazle Township, PA - 182022858 |
| Business Phone Number: | 5704543052 |
| Business Fax Number: | 5704533176 |
| Mailing Address: | 529 Hillside Dr, HAZLE TOWNSHIP |
| State: | PA |
| Postal Code: | 182022858 |
| Phone Number: | 5704543052 |
| Fax Number: | 5704533176 |
| NPI Enumeration Date: | 12/26/2013 |
| NPI Last Update Date: | 12/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP013099 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |