Provider Demographics
NPI:1518107515
Name:THAKOR, DIMPLE DILIPBHAI (CRNP, FNP)
Entity Type:Individual
Prefix:
First Name:DIMPLE
Middle Name:DILIPBHAI
Last Name:THAKOR
Suffix:
Gender:F
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 RICE MINE RD NE STE 10
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-3136
Mailing Address - Country:US
Mailing Address - Phone:205-333-9467
Mailing Address - Fax:205-758-1435
Practice Address - Street 1:4960 RICE MINE RD NE STE 10
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3136
Practice Address - Country:US
Practice Address - Phone:205-333-9467
Practice Address - Fax:205-758-1435
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101894363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner