Healthcare Provider Details

I. General information

NPI: 1265321657
Provider Name (Legal Business Name): BOBBI SUE THATCHER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8263 CIRCLE RD
BERLIN MD
21811-2119
US

IV. Provider business mailing address

PO BOX 973
WESTMINSTER MD
21158-0973
US

V. Phone/Fax

Practice location:
  • Phone: 443-397-1122
  • Fax:
Mailing address:
  • Phone: 410-848-5785
  • Fax: 410-848-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR224682
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: