Provider Demographics
NPI:1538799390
Name:THOMAS, SISY (NP)
Entity type:Individual
Prefix:
First Name:SISY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SISY
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3643 E ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1848
Mailing Address - Country:US
Mailing Address - Phone:480-664-8988
Mailing Address - Fax:
Practice Address - Street 1:HU HU KAM MEMORIAL HOSPITAL
Practice Address - Street 2:483 W. SEED FARM RD
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147
Practice Address - Country:US
Practice Address - Phone:602-528-1458
Practice Address - Fax:602-271-7870
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247977207Q00000X, 207QA0505X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine