Provider Demographics
NPI:1912142993
Name:THOMASON, ERNEST LOWELL JR (RN)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:LOWELL
Last Name:THOMASON
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:122 JK GRAY LN
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3725
Mailing Address - Country:US
Mailing Address - Phone:423-773-3319
Mailing Address - Fax:
Practice Address - Street 1:122 JK GRAY LN
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-3725
Practice Address - Country:US
Practice Address - Phone:423-773-3319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN132328163WR0006X
TN95-111246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant