Provider Demographics
NPI:1801349469
Name:THOMAS, LARRA SCOTT (NP-C)
Entity type:Individual
Prefix:
First Name:LARRA
Middle Name:SCOTT
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1926 ALCOA HWY
Mailing Address - Street 2:MEDICAL BUILDING F SUITE 370
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1545
Mailing Address - Country:US
Mailing Address - Phone:865-305-5622
Mailing Address - Fax:865-305-4580
Practice Address - Street 1:1926 ALCOA HWY
Practice Address - Street 2:MEDICAL BUILDING F SUITE 370
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-305-5622
Practice Address - Fax:865-305-4580
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000021288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily