Provider Demographics
NPI:1801076443
Name:THOMAS, MAYA N (LPN)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:N
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:N
Other - Last Name:THOMAS-NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1470 S QUEBEC WAY
Mailing Address - Street 2:#208
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5696
Mailing Address - Country:US
Mailing Address - Phone:720-748-7901
Mailing Address - Fax:
Practice Address - Street 1:1375 E 20TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5423
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42316164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse