Provider Demographics
NPI:1669810248
Name:THOMAS, OLAYINKA ELIZABETHO
Entity type:Individual
Prefix:MRS
First Name:OLAYINKA
Middle Name:ELIZABETHO
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:OLAYINKA
Other - Middle Name:ELIZABETHO
Other - Last Name:CAULCRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:68 IRON CREEK CV
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-6999
Mailing Address - Country:US
Mailing Address - Phone:901-314-0938
Mailing Address - Fax:
Practice Address - Street 1:2986 KATE BOND RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4003
Practice Address - Country:US
Practice Address - Phone:901-820-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN109194163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical