Individual
LESLIE W THIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10448 OLD OLIVE STREET RD, SUITE 100, CREVE COEUR, MO 63141-5924
(314) 743-8098
Mailing address
13523 BARRETT PARKWAY DR, SUITE 210, BALLWIN, MO 63021-3802
(314) 775-2816
(314) 775-2821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
080623
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915233126
—
MO
01
—
P00307916
RR MEDICARE
MO
Enumeration date
11/18/2005
Last updated
05/21/2008
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