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Individual
JOYCE DENISE THACKER
Active
Individual
JOYCE DENISE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-AG
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
3009100
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
3009100
KY
363LG0600X
Gerontology Nurse Practitioner
3009100
KY
Other
Enumeration date
07/17/2015
Last updated
09/23/2015
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