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Individual
MR. ADRIAN SCOTT THACKER
Active
Individual
MR. ADRIAN SCOTT THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
0024173601
VA
363L00000X
Nurse Practitioner
Primary
0024173601
VA
363LF0000X
Family Nurse Practitioner
0024173601
VA
Other
Enumeration date
06/07/2016
Last updated
02/25/2026
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