Individual provider · Type 1 NPI

Ashley Lilly Thacker, FNP-C

Family Nurse Practitioner · South Charleston, WV

NPI number 1679084628 Active

Practice location

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311

Mailing address

21 Michael St
Scott Depot, WV 25560-9534

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XAPRN71553-NP-C (WV)

Family Nurse Practitioner: Definition to come...

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About NPI 1679084628

Ashley Lilly Thacker, FNP-C's National Provider Identifier is 1679084628, issued on Oct 17, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in South Charleston, WV. The record was last updated on Oct 17, 2017.