Thacker, Brianna R
Thacker, Brianna R is an individual health care provider with primary practice located at 717 N 190Th Plz Ste 3200 , Elkhorn NE 68022-3913. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Thacker, Brianna R can be contacted via phone (402) 815-1980.Contact Information
Primary practice address
717 N 190Th Plz Ste 3200
Elkhorn NE 68022-3913
Phone: (402) 815-1980
Fax: (402) 815-1961
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2332 | Nebraska |
Profile Details
| NPI number | 1235695198 |
|---|---|
| LBN Legal business name | Thacker, Brianna R |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2019 |
| Last updated | Mar 26th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235695198 | NPPES |
| Iowa | MEDICAID | 1235695198 | |
| Iowa | MEDICAID | 10026293200 | |
| Iowa | MEDICAID | 47068731734 | |
| Iowa | MEDICAID | 10026480100 | |
| Iowa | MEDICAID | 47068731749 | |
| Iowa | MEDICAID | 47068731741 |
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