Provider Demographics
NPI:1154787638
Name:THOMAS, ALICIA R (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:R
Other - Last Name:CLIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2040 E SUNSHINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1815
Mailing Address - Country:US
Mailing Address - Phone:417-275-8900
Mailing Address - Fax:417-270-8012
Practice Address - Street 1:2040 E SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1815
Practice Address - Country:US
Practice Address - Phone:417-275-8900
Practice Address - Fax:417-270-8012
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015041113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily