1902982903 NPI number — ANNE M. THATCHER APRN

Table of content: ANNE M. THATCHER APRN (NPI 1902982903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902982903 NPI number — ANNE M. THATCHER APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THATCHER
Provider First Name:
ANNE
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUCAS
Provider Other First Name:
ANNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902982903
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 706
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03264-0706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-481-8757
Provider Business Mailing Address Fax Number:
603-238-2163

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 BOULDER POINT DRIVE
Provider Second Line Business Practice Location Address:
SPEARE PRIMARY CARE
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-536-1181
Provider Business Practice Location Address Fax Number:
603-238-2198
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  026825-23-03 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 026825-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1021535 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 026825-23-03 . This is a "ARNP - FNP LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 026825-21 . This is a "RN LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3078893 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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