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Individual
JACQUELYN MARIE THAYER
Active
Individual
JACQUELYN MARIE THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
203871
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
THAY-6BQ212
NC
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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