| Doctor Name: | MARY J. THAYER |
| NPI Number: | 1578602835 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., A.R.N.P. |
| License Number: | 047901-23-08 |
| Business Practice Address: | 2977 White Mountain Hwy North Conway, NH - 038605111 |
| Business Phone Number: | 6033563100 |
| Business Fax Number: | 6033567421 |
| Mailing Address: | Po Box 2325, NORTH CONWAY |
| State: | NH |
| Postal Code: | 038602325 |
| Phone Number: | 6033563100 |
| Fax Number: | 6033567421 |
| NPI Enumeration Date: | 02/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 047901-23-08 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |