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Individual

PAIGE THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
109 HOLLY TREE CIR, HENDERSONVILLE, NC 28792-9104
(304) 928-9919
Mailing address
109 HOLLY TREE CIR, HENDERSONVILLE, NC 28792-9104
(304) 928-9919

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
95179293
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G167674
IA

Other

Enumeration date
10/05/2019
Last updated
03/04/2022
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