Healthcare Provider Details

I. General information

NPI: 1376944249
Provider Name (Legal Business Name): MARGARET THAYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2014
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 N 3RD AVE
PHOENIX AZ
85013-3903
US

IV. Provider business mailing address

2390 E CAMELBACK RD
PHOENIX AZ
85016-3448
US

V. Phone/Fax

Practice location:
  • Phone: 602-776-7676
  • Fax: 602-776-3002
Mailing address:
  • Phone: 602-834-3913
  • Fax: 866-522-8033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5783
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5783
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5783
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: