Provider Demographics
NPI:1912154402
Name:THOMAS, DIONNE LORRAINE
Entity type:Individual
Prefix:MISS
First Name:DIONNE
Middle Name:LORRAINE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DIONNE
Other - Middle Name:LORRAINE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:20934 86TH DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1545
Mailing Address - Country:US
Mailing Address - Phone:347-570-6955
Mailing Address - Fax:
Practice Address - Street 1:20934 86TH DR APT 2A
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1545
Practice Address - Country:US
Practice Address - Phone:347-570-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279487164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse