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Individual

MS. NANCY LEE THACKER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
1141 E 3900 S, SALT LAKE CITY, UT 84124-1215
(801) 284-4990
(801) 284-4991
Mailing address
823 W 1440 N, OREM, UT 84057-2952
(801) 270-6517
(801) 284-4991

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
1960183102
UT

Other

Enumeration date
12/06/2005
Last updated
07/08/2007
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