Individual
MRS. TAMMY LEE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2327 ENGLERT DR STE 101, DURHAM, NC 27713-4447
(919) 572-2978
Mailing address
2327 ENGLERT DR STE 101, DURHAM, NC 27713-4447
(919) 572-2978
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
3418407
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418407
—
NC
Enumeration date
06/16/2008
Last updated
06/16/2008
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