Individual provider · Type 1 NPI

Madison Thalacker, PA-C

Student in an Organized Health Care Education/Training Program · Minneapolis, MN

NPI number 1639928013 Active

Practice location

2211 Riverside Ave
Minneapolis, MN 55454-1350

Call (612) 330-1399 Map

Mailing address

1010 Sussex Dr
Eau Claire, WI 54703-2096

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1639928013

Madison Thalacker, PA-C's National Provider Identifier is 1639928013, issued on May 16, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Minneapolis, MN. The record was last updated on Oct 19, 2026.