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Individual

MR. JONATHAN R THIELE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
112 N 7TH ST, CHAMBERSBURG, PA 17201-1720
(717) 267-7164
(717) 267-7414
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
R189735
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
RN564516
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14125175
CAQH
Enumeration date
01/17/2011
Last updated
10/06/2025
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