Provider Demographics
NPI:1083402044
Name:THOMAS, LYNETTE R
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2622
Mailing Address - Street 2:
Mailing Address - City:BELCOURT
Mailing Address - State:ND
Mailing Address - Zip Code:58316-2622
Mailing Address - Country:US
Mailing Address - Phone:701-550-1616
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2622
Practice Address - Street 2:
Practice Address - City:BELCOURT
Practice Address - State:ND
Practice Address - Zip Code:58316-2622
Practice Address - Country:US
Practice Address - Phone:701-550-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No376K00000XNursing Service Related ProvidersNurse's Aide
No251J00000XAgenciesNursing Care