Provider Demographics
NPI:1639421225
Name:THAYER, ERIN DANIELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:DANIELLE
Last Name:THAYER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:DANIELLE
Other - Last Name:BRUNGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2629 FAIRVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9084
Mailing Address - Country:US
Mailing Address - Phone:615-799-2389
Mailing Address - Fax:
Practice Address - Street 1:2629 FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-9084
Practice Address - Country:US
Practice Address - Phone:615-799-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily