Individual
CHRISTINA THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-4691
Mailing address
2561 E 1500 S, VERNAL, UT 84078-9137
(435) 828-5954
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
190006-4405
UT
Other
Enumeration date
10/13/2016
Last updated
01/25/2023
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