Provider Demographics
NPI:1386482073
Name:THOMAS, SIERRA NICHOLLE (FNP)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:NICHOLLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N BELT LINE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1770
Mailing Address - Country:US
Mailing Address - Phone:469-445-0802
Mailing Address - Fax:469-334-2253
Practice Address - Street 1:1010 N BELT LINE RD STE 104
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1770
Practice Address - Country:US
Practice Address - Phone:469-445-0802
Practice Address - Fax:469-334-2253
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1051162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily