Individual
ROBERT SLADE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN CFNP
Contact information
Practice address
712 AVIATION WAY, CALDWELL, ID 83605-1154
(208) 302-7100
(208) 302-7155
Mailing address
1906 FAIRVIEW AVE, STE. 230, CALDWELL, ID 83605-5407
(208) 459-4667
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1096A
ID
Other
Enumeration date
09/01/2011
Last updated
08/07/2025
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