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1679084628
ASHLEY LILLY THACKER
SOUTH CHARLESTON, WV
NPI
1679084628
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: WV APRN71553-NP-C)
Enumeration Date
2017-10-17
Last Update Date
2017-10-17
Business Address
ASHLEY LILLY THACKER FNP-C
4605 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309-1311
Phone number: 304-766-5650
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Mailing Address
ASHLEY LILLY THACKER FNP-C
21 MICHAEL ST
SCOTT DEPOT, WV 25560-9534
Phone number: 304-228-7291
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