Individual
KATHRYN THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
516 W 14TH AVE STE 100, HOLDREGE, NE 68949
(308) 955-4431
(308) 995-3247
Mailing address
516 W 14TH AVE STE 100, HOLDREGE, NE 68949-1215
(089) 955-4431
(308) 995-3247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1662
NE
207Q00000X
Family Medicine Physician
TEP7575
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470553011-00
—
NE
Enumeration date
07/07/2015
Last updated
08/15/2018
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