Shaundrele Evette Thomas

Individual provider Active NPI Phlebotomy Technician · Nesbit, MS

NPI 1689375172 · NPPES record last updated Mar 13, 2023

Key facts

NPI
1689375172
Entity type
Individual (NPI type 1)
Primary specialty
Phlebotomy Technician 246RP1900X
License
10725 (MS)
Practice address
1151 Highway 51 N Lot 335
Nesbit, MS 38651-8446
Phone
(662) 420-8814
NPI assigned
Mar 13, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10725MSMDOphthalmology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
246RP1900X 10725 MS Yes

Addresses

Primary practice location

1151 Highway 51 N Lot 335
Nesbit, MS 38651-8446

Mailing address

1151 Highway 51 N Lot 335
Nesbit, MS 38651-8446
Phone (662) 420-8814

Other providers in Nesbit, MS

All providers in Nesbit, MS · Phlebotomy Technician in Mississippi

Sources for this page

Verify at the official NPI Registry.