Individual
MRS. MARYANN MOULDER THRASHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4117 S. 240 W. SUITE 200 PROACTIVE MD., NEWTON COUNTY GOV/ SUITE 200, MORROCO, IN 47963
(219) 209-4400
(833) 525-2450
Mailing address
4117 S 240 W STE 200, MOROCCO, IN 47963-8194
(219) 209-4400
(833) 525-2450
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
RN174775
GA
363LF0000X
Family Nurse Practitioner
NP174775
GA
Other
Enumeration date
07/07/2008
Last updated
03/03/2026
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