Provider Demographics
NPI:1538035183
Name:THOMAS, JUANITA D
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CORDOBA CT
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:DE
Mailing Address - Zip Code:19734-3819
Mailing Address - Country:US
Mailing Address - Phone:410-841-8894
Mailing Address - Fax:
Practice Address - Street 1:700 CORDOBA CT
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:DE
Practice Address - Zip Code:19734-3819
Practice Address - Country:US
Practice Address - Phone:410-841-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0051722163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse