| NPI | 1356761498 | 
|---|---|
| Former Name | MARCI LEIGH THAYNE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7714660-4405) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7714660-3102) | 
| 163WG0000X Registered Nurse, General Practice (Licence: UT 7714660-3102) | |
| Enumeration Date | 2014-04-16 | 
| Last Update Date | 2022-12-11 |