Individual
MS. DONNA CAROLE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
13737 SPOTSWOOD TRL, ELKTON, VA 22827-3200
(540) 713-4100
(757) 578-8587
Mailing address
PO BOX 1430, HARRISONBURG, VA 22803-1430
(540) 564-5644
(540) 564-6847
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024169551
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477832731
—
VA
Enumeration date
08/04/2011
Last updated
05/08/2017
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