KELLY THALACKER (NPI# 1184263451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184263451 |
| Entity Type | Individual |
| Full Name | KELLY THALACKER |
| Practice Address |
41 Corporate Dr # 101 Easton PA 18045-2670 |
| Mailing Address |
1605 N Cedar Crest Blvd Ste 411 Allentown PA 18104-2323 |
| Practice Telephone | 6105599330 |
| Mailing Telephone | 6109691915 |
| Mailing Fax Number | 4846647659 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | SP020519 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
SP020519 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 206 E Brown St, East Stroudsburg, PA 183013006 | 5704247764 | 5704210760 |
| 755 Memorial Pkwy Ste 202a, Phillipsburg, NJ 088652773 | 9088595400 |
| Street Address |
41 CORPORATE DR # 101 |
| City | EASTON |
| State | PA |
| Zip Code | 18045-2670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528685492 | Shilpa Salpekar | Internal Medicine | St. Lukes Internal Medicine (easton), 400 S Greenwood Ave, Easton, PA 18045 | 2020-06-26 |
| 1194340224 | Alex Grieco | Internal Medicine | 1700 St. Luke's Blvd., Anderson Medical Education Office, Easton, PA 18045 | 2020-06-15 |
| 1609403112 | Jesse Anderson | Social Worker | 1303c Nicholas St, Easton, PA 18045 | 2020-03-25 |
| 1619538865 | Unknown Azima Shaji | Psychiatry & Neurology | St. Luke's University and Health Network- Anderson, Medical Education Office- 1700, St. Luke's Blvd, Easton, PA 18045 | 2019-06-27 |
| 1679131866 | Kamaldeep Sethi | Family Medicine | 1700 St. Luke's Blvd, Medical Education Office, Easton, PA 18045 | 2019-06-03 |
| 1952849606 | Lehigh Valley Physician Group | Family Medicine | 2401 Northampton St, 1st Floor, Easton, PA 18045 | 2017-02-02 |
| 1760854392 | Dental Professionals of Pennsylvania, PC | Dentist | 4727 Freemansburg Ave, Suite 104, Easton, PA 18045 | 2015-10-22 |
| 1114318870 | Shanthi Narla | Student in an Organized Health Care Education/Training Program | St. Luke's Hospital-anderson Campus, Dermatology, Easton, PA 18045 | 2015-02-16 |
| 1891108718 | Danielle Johnson | Obstetrics & Gynecology | 2200 St. Luke's Blvd, Suite 200, Easton, PA 18045 | 2014-06-09 |
| 1023451085 | Matthew S Yoder | Anesthesiology | 3500 Corriere Rd Apt 100, Easton, PA 18045 | 2013-04-09 |
| Find all providers in zip 18045 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285148619 | Sandra L Ewing | Nurse Practitioner | 3735 Nazareth Rd Ste 206, Easton, PA 18045-8346 | 2017-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063873 | Latasha Evans | Nurse Practitioner | 7440 Rogers Ave, Upper Darby, PA 19082-2010 | 2020-11-03 |
| 1386243830 | Kevin Khoa Nguyen | Nurse Practitioner | 6028 Pine Valley Ln, Fairview, PA 16415-3272 | 2020-10-25 |
| 1255938163 | Nicole Pfeiffer | Nurse Practitioner | 1932 Washington Ln, Meadowbrook, PA 19046-1138 | 2020-10-04 |
| 1508471582 | Yanshi Lin | Nurse Practitioner | 1400 Spring Garden St Apt 904, Philadelphia, PA 19130-4411 | 2020-09-15 |
| 1629683115 | Meghan Bonner | Nurse Practitioner | 333 N Oxford Valley Rd Ste 102, Fairless Hills, PA 19030-2626 | 2020-09-10 |
| 1245850270 | Lori Michele Shotts | Nurse Practitioner | 110 Holmes St, Vandergrift, PA 15690-1658 | 2020-04-20 |
| 1669008140 | Tracy Shenk | Nurse Practitioner | 60 Versailles Ct, Reading, PA 19605-7019 | 2020-03-17 |
| 1346889524 | Crystal Parker | Nurse Practitioner | 816 Laurel Rd, Lansdowne, PA 19050-3609 | 2020-01-05 |
| 1821636317 | Mary Mumbi Njogu | Nurse Practitioner | 907 Woodbrook Ln, Philadelphia, PA 19150-3217 | 2019-12-15 |
| 1790336543 | Angela Olarte | Nurse Practitioner | 1627 Chew St Ste 403, Allentown, PA 18102-3648 | 2019-09-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.