Thacker, Teresa A

Thacker, Teresa A is an individual health care provider with primary practice located at 260 Beth Stacey Blvd Ste C , Lehigh Acres FL 33936-6074. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Thacker, Teresa A can be contacted via phone (239) 343-9888.

Contact Information

Primary practice address
260 Beth Stacey Blvd Ste C Lehigh Acres FL 33936-6074
Phone: (239) 343-9888
Fax: (239) 303-0714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP9449096 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9449096 Florida

Profile Details

NPI number 1326152570
LBN Legal business name Thacker, Teresa A
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Mar 30th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326152570 NPPES
Kentucky MEDICAID 7100013940
Kentucky Other 1326152570

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