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1710676713
MYRANDA NICOLE THOMAS
CARBONDALE, IL
NPI
1710676713
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Former Name
MYRANDA COMPTON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209026612)
Enumeration Date
2023-05-04
Last Update Date
2023-06-21
Business Address
MYRANDA NICOLE THOMAS
2601 W MAIN ST
CARBONDALE, IL 62901-1031
Phone number: 618-549-5361
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Mailing Address
MYRANDA NICOLE THOMAS
PO BOX 3988
CARBONDALE, IL 62902-3988
Phone number: 618-457-5200
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