MICHELLE MACEY THACKER

LAWRENCEVILLE, IL
NPI1073003588
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71010904A)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: IL  209017621)
Enumeration Date2018-05-10
Last Update Date2023-04-20
Business Address
MICHELLE MACEY THACKER NP-C
2111 LEXINGTON AVE
LAWRENCEVILLE, IL 62439
Phone number: 618-943-7214
Mailing Address
MICHELLE MACEY THACKER NP-C
2111 LEXINGTON AVE
LAWRENCEVILLE, IL 62439
Phone number: