Individual
TAMMY JUNE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
206 HALF MOON RD, OLIVER SPRINGS, TN 37840-6105
(865) 617-7803
(865) 435-2381
Mailing address
206 HALF MOON RD, OLIVER SPRINGS, TN 37840-6105
(865) 617-7803
(865) 435-2381
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
44150
TN
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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