SearchTennessee363LF0000X

Michael Thacker, FNP-C

NPI 1205399508 · on the registry since 2019

Practice

Address
403 Princeton Rd Ste 3
Johnson City, TN 37601
Phone
(423) 302-3681
Fax
(423) 302-3689
Organisation at this address
Allergy Associates Pa
Southern Orthocare Inc
Wellspring Healthcare, Pllc
Allen Allied Healthcare Inc.
Blue Ridge Medical Management Corpoartion
Inferred from a shared address, not stated in the registry.
Clinicians at this address
22

Additional practice sites

  • 100 Clinchfield St, Kingsport, TN

Registry record

Primary taxonomy
363LF0000X
363LF0000X
Also registered as
363LF0000X
Licence states on file
TN, VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-05-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee