Individual
JENNIFER MARGARET THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3003 W DR MARTIN LUTHER KING JR BLVD, MAB 3RD FLOOR, TAMPA, FL 33607-6307
(813) 870-4438
Mailing address
7824 BALLY MONEY RD, TAMPA, FL 33610-8067
(585) 469-4763
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9252067
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP9252067
ARNP LICENSE
FL
Enumeration date
07/10/2007
Last updated
09/14/2010
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