Individual
DR. GRACE NICOLE THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
92 N DEAN RD STE 100, ORLANDO, FL 32825-3769
(407) 916-0304
Mailing address
845 E CHARING CROSS CIR, LAKE MARY, FL 32746-3774
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11021558
FL
363LF0000X
Family Nurse Practitioner
11021558
FL
Other
Enumeration date
08/31/2022
Last updated
03/22/2023
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