Provider Demographics
NPI:1790832772
Name:THRASHER, MISTY DAWN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MISTY
Middle Name:DAWN
Last Name:THRASHER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:MISTY
Other - Middle Name:DAWN
Other - Last Name:HESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1000 S JACKSON HWY
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5761
Mailing Address - Country:US
Mailing Address - Phone:256-389-3567
Mailing Address - Fax:
Practice Address - Street 1:1000 S JACKSON HWY
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5761
Practice Address - Country:US
Practice Address - Phone:256-389-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094526363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ17826Medicare UPIN
AL051554853HESMedicare ID - Type Unspecified