Individual
BROOKE A THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, BSN, RN
Contact information
Practice address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 862-1400
Mailing address
10191 EVENDALE COMMONS DR, CINCINNATI, OH 45241-2689
(513) 520-2676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
414355
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0020466
OH
Other
Enumeration date
07/11/2021
Last updated
08/26/2025
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