Provider Demographics
NPI:1760292916
Name:THOMAS, KIRSTEN A (HIS)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 N SAWYER ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-4252
Mailing Address - Country:US
Mailing Address - Phone:920-235-8080
Mailing Address - Fax:
Practice Address - Street 1:331 N SAWYER ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-4252
Practice Address - Country:US
Practice Address - Phone:920-235-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2072-69237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist