Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gwendolyn Irene Thacker, CNP

Individual provider Nurse Practitioner · NPI 1619302791

Gwendolyn Irene Thacker, CNP is a Nurse Practitioner in Miamisburg, Ohio. Graduated from University of Cincinnati College of Medicine in 2013, 13 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
13
Trained at
University of Cincinnati College of Medicine
Licensed in
OH
In the registry since
2013
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4000 Miamisburg Centerville Rd Ste 110
Miamisburg, OH 45342-7615
Phone: (937) 865-9000
Fax: (937) 865-9002
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence COA.14947-NP (OH)

Record details

NPI number1619302791
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorYes
NPI enumeratedSeptember 9, 2013
Last updated in NPPESNovember 17, 2020
Certification dateNovember 17, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Miamisburg