Individual
ERIC DUANE THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
5424 GLENWOOD ST, DULUTH, MN 55804-1332
(651) 276-2700
Mailing address
5424 GLENWOOD ST, DULUTH, MN 55804-1332
(651) 276-2700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A164805
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A164805
IOWA BOARD OF NURSING ARNP LICENSE
IA
Enumeration date
07/27/2021
Last updated
07/27/2021
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