Provider Demographics
NPI:1225072580
Name:THAYER, DEBRA WELLS (NP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:WELLS
Last Name:THAYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6525 BELCREST RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2003
Mailing Address - Country:US
Mailing Address - Phone:301-560-2944
Mailing Address - Fax:301-560-2945
Practice Address - Street 1:100 IRVING ST NW # 4131
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-8946
Practice Address - Fax:202-877-6775
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2018-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDAC000217363LA2200X
VA0024071247363LF0000X
DCRN43659363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily