ANDREA L THACKER ARNP NPI 1457163248

NPI Information

  • NPI: 1457163248
  • Provider Name: ANDREA L THACKER, ARNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 801 HARMONY ST STE 302
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Phone: (712) 328-2690

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NPI Details

Andrea L Thacker, ARNP is a psychiatric/mental health nurse practitioner in Council Bluffs, IA with 2 years of experience. Andrea L Thacker, ARNP NPI is 1457163248. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

801 HARMONY ST STE 302
COUNCIL BLUFFS, IA
ZIP 51503-106
Phone: (712) 328-2690
Fax: (712) 328-9257

The NPI 1457163248 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/21/2025 and was last updated on 1/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthG182876IOWAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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