Individual
DR. BRYCE J THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CNS, FNP-C
Contact information
Practice address
2373 CENTRAL PARK BLVD UNIT 100, DENVER, CO 80238-2300
(833) 351-8255
Mailing address
393 ELDRIDGE ST, BURLINGTON, CO 80807-1356
(719) 343-5388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN.00005929-NP
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN.0005929-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495796
—
IA
05
—
1495796
—
IA
05
—
47068731708
—
NE
05
—
47068731777
—
NE
05
—
71638741
—
CO
Enumeration date
06/22/2006
Last updated
05/12/2025
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