Provider Demographics
NPI:1538428271
Name:THOMAS, TASHRA SHANALE (APRN)
Entity type:Individual
Prefix:MISS
First Name:TASHRA
Middle Name:SHANALE
Last Name:THOMAS
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MAIL STOP 1072
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-3961
Mailing Address - Fax:913-588-8786
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MAIL STOP 1072
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-3961
Practice Address - Fax:913-588-8786
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2017-03-28
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Provider Licenses
StateLicense IDTaxonomies
KS53-75526-011363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health