Provider Demographics
NPI:1851136535
Name:ERLE THOMAS, NAOMI DAWN (CHW, LADC)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:DAWN
Last Name:ERLE THOMAS
Suffix:
Gender:F
Credentials:CHW, LADC
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 280
Mailing Address - Street 2:
Mailing Address - City:RED LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56671-0280
Mailing Address - Country:US
Mailing Address - Phone:218-679-3228
Mailing Address - Fax:
Practice Address - Street 1:403 4TH ST NW STE 120
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3155
Practice Address - Country:US
Practice Address - Phone:218-444-2718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker