| Doctor Name: | MRS. PAMELA S. THACKER |
| NPI Number: | 1013138403 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R,N., BSN, PHN, LCCE |
| License Number: | 213977 |
| Business Practice Address: | 11484 B Ave Auburn, CA - 956032603 |
| Business Phone Number: | 5308863462 |
| Business Fax Number: | 5308897198 |
| Mailing Address: | 11484 B Ave, AUBURN |
| State: | CA |
| Postal Code: | 956032603 |
| Phone Number: | 5308863462 |
| Fax Number: | 5308897198 |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 213977 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |