Basic Information
Provider Information
NPI: 1073184982
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THRIFT MANN
FirstName: ANNIE
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: DNP, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 CAMPUS BLVD STE 100
Address2:  
City: WINCHESTER
State: VA
PostalCode: 226012896
CountryCode: US
TelephoneNumber: 5405365100
FaxNumber: 5405360235
Practice Location
Address1: 120 CAMPUS DR STE 101
Address2:  
City: MARTINSBURG
State: WV
PostalCode: 254047552
CountryCode: US
TelephoneNumber: 6812471250
FaxNumber: 6812471251
Other Information
ProviderEnumerationDate: 07/02/2021
LastUpdateDate: 05/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XR188074MDN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000X111938WVY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home