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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KELLY THALACKER

Active

KELLY THALACKER is a Gerontological Nurse Practitioner healthcare provider located in EASTON, Pennsylvania. NPI 1184263451 is currently active in the NPPES registry. Verify at CMS.

Gerontological Nurse Practitioner · EASTON, PA

Registration Details

NPI Number
1184263451
Provider Type
Individual
Gender
Female
NPI Issued
Jan 3, 2020 (6.6558675617829 yrs)
Last Updated
Apr 14, 2020
Licenses
SP020519 (PA)
SP020519 (PA)

Practice Information

Address
41 CORPORATE DR # 101
EASTON, PA, 180452670
Browse PA providers · Browse ZIP 18045
Phone
6105599330
Primary Specialty
Gerontological Nurse Practitioner
363LG0600X

Other Gerontological Nurse Practitioner Providers in EASTON, PA

Name Credential NPI
SANDRA L EWING NP 1285148619
REBECCA L DEJESUS 1104305887
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.