Individual
JENNY L THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7301 OHMS LN, SUITE 650, EDINA, MN 55439-2331
(952) 835-9880
(952) 857-1554
Mailing address
7301 OHMS LN, SUITE 650, EDINA, MN 55439-2331
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32400
AZ
207P00000X
Emergency Medicine Physician
44616
MN
Other
Enumeration date
07/31/2006
Last updated
07/14/2008
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