MARK THALACKER, CNP

Nurse Practitioner

Active Individual
NPI: 1063483493

Practice Address

1875 WOODWINDS DR
SUITE 130
Woodbury, MN 55125

Phone: (651) 232-0500

Specialties

Specialty Code Primary License
Nurse Practitioner 363L00000X Yes R096321-5 (MN)

Frequently Asked Questions

NPI 1063483493 is the National Provider Identifier for MARK THALACKER, CNP, a Nurse Practitioner provider located in Woodbury, MN. This NPI was enumerated on February 1, 2006.
MARK THALACKER, CNP practices at 1875 WOODWINDS DR, SUITE 130, Woodbury, MN 55125.

Quick Facts

NPI
1063483493
Type
Individual
Enumerated
Feb 1, 2006
Last Updated
Feb 26, 2024

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