Individual
SARA BRATCHER THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
14866 OCEAN HWY, PAWLEYS ISLAND, SC 29585-4801
(843) 235-0760
(843) 235-3026
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
20600
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4343
—
SC
Enumeration date
11/21/2016
Last updated
06/10/2021
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