Individual provider · Type 1 NPI
Gwendolyn Irene Thacker, CNP
Nurse Practitioner · Miamisburg, OH
Practice location
4000 Miamisburg Centerville Rd, Suite 110
Miamisburg, OH 45342-7615
Fax (937) 865-9002
Mailing address
4000 Miamisburg Centerville Rd Ste 110
Miamisburg, OH 45342-3674
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | COA.14947-NP (OH) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1619302791
Gwendolyn Irene Thacker, CNP's National Provider Identifier is 1619302791, issued on Sep 9, 2013. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Miamisburg, OH. The record was last updated on Nov 17, 2020.