Individual
MRS. ELLEN TRACY THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744
(727) 398-6661
Mailing address
7028 40TH AVE N, ST PETERSBURG, FL 33709-4612
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP2793512
FL
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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