Individual
MRS. HOLLY THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 W NORFOLK AVE, NORFOLK, NE 68701-4438
(402) 844-8126
Mailing address
2700 W NORFOLK AVE, NORFOLK, NE 68701-4438
(402) 844-8126
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
1088
NE
133V00000X
Registered Dietitian
1088
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1088
STATE OF NEBRASKA HHS MEDICAL NUTITION THERAPIST LICENSE
NE
01
—
963990
CDR REGISTERED DIETITIAN
—
Enumeration date
04/22/2014
Last updated
09/16/2022
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