Individual
PENNY JANE THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3152 CANAL PL, LAND O LAKES, FL 34639-4503
(813) 607-0079
Mailing address
3152 CANAL PL, LAND O LAKES, FL 34639-4503
(813) 607-0079
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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