Individual
BRITTANY THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 967-5570
(479) 890-5364
Mailing address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 890-5364
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L45937
AR
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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