Individual
MR. LOREN B THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CRNA
Contact information
Practice address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-2122
Mailing address
PO BOX 1385, IDAHO FALLS, ID 83403-1385
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
192490704
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114342500
—
WY
01
—
311834
BCBS
WY
01
—
P00065251
RAILROAD MC
—
Enumeration date
09/28/2006
Last updated
02/15/2018
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