Individual provider · Type 1 NPI
Jermaine Dario Okang Thomas, AGPCNP-BC
Gerontology Nurse Practitioner · Boston, MA
NPI number
1104471416
Active
Practice location
801 Massachusetts Ave, 2nd Fl
Boston, MA 02118-0211
Fax (617) 414-4676
Mailing address
801 Albany St Fl Ground
Boston, MA 02119-2560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | RN2320575 (MA) |
| Acute Care Nurse Practitioner | 363LA2100X | RN2320575 (MA) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | RN2320575 (MA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1104471416
Jermaine Dario Okang Thomas, AGPCNP-BC's National Provider Identifier is 1104471416, issued on Aug 4, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Boston, MA. The record was last updated on Nov 11, 2021.