Individual
KATHY JO THIEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2505 1ST AVE E, LA CROSSE, WI 54603-1203
(608) 317-1180
Mailing address
2505 1ST AVE E, LA CROSSE, WI 54603-1203
(608) 317-1180
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
141043-30
WI
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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