Individual
MRS. GLYNNIS L THATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
13121 OLIO RD STE 300, FISHERS, IN 46037
(317) 621-1300
(317) 621-1310
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
(317) 621-7547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002292A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200904280
—
IN
01
—
251K00000X
PUBLIC HEALTH
IN
Enumeration date
07/26/2006
Last updated
11/27/2023
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