Ryan Thacker

Individual provider Active NPI Home Health Aide · Glen Daniel, WV

NPI 1023945268 · NPPES record last updated May 4, 2026

Key facts

NPI
1023945268
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
145 Logan Tpke
Glen Daniel, WV 25844
Phone
(304) 578-9852
NPI assigned
May 4, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Yes

Addresses

Primary practice location

145 Logan Tpke
Glen Daniel, WV 25844

Mailing address

PO Box 63
Fairdale, WV 25839-0063

Other providers in Glen Daniel, WV

All providers in Glen Daniel, WV · Home Health Aide in West Virginia

Sources for this page

Verify at the official NPI Registry.