person
Amanda Lee Thacker, FNP
Family Nurse Practitioner in Leesburg, Virginia
NPI 1114621810

Amanda Lee Thacker is a Family Nurse Practitioner based in Leesburg, VA and is specialized in Family. Amanda Lee Thacker practices in Leesburg, VA and has the professional credentials of FNP. The NPI Number for Amanda Lee Thacker is 1114621810 and holds a License No. 0024185322 (Virginia).

The current practice location address for Amanda Lee Thacker is 19450 Deerfield Avenue, Suite 200, Leesburg, VA and can be reached out via phone at 703-844-8380 and via fax at 703-263-8393.

Location: 19450 Deerfield Avenue, Suite 200, Leesburg, VA, 20176-2704
person
Provider Profile Details
NPI Number
1114621810
Provider Name
Amanda Lee Thacker
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
19450 Deerfield Avenue, Suite 200, Leesburg, VA, 20176-2704
Phone Number
703-844-8380
Fax Number
703-263-8393
Provider Enumeration Date
03/28/2023
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30017651500001 05 VA
1114621810 05 VA
institution
Provider Business Practice Location Address Details
Address
19450 Deerfield Avenue, Suite 200
City
State
Zip
20176-6821
Phone Number
703-844-8380
Fax Number
703-263-8393
person
Provider Business Mailing Address Details
Address
19450 Deerfield Avenue, Suite 200
City
State
Zip
20176-6821
Phone Number
703-844-8380
Fax Number
703-263-8393
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
0024185322 (Virginia)
Definition
Definition to come...
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