Individual
KAREN LEIGH THEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
R0992639
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
R099263-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400764
MEDICA HEALTH PLANS
—
01
—
122228
U CARE
—
01
—
227323300
MEDICAL ASSISTANCE
—
01
—
41Q38CO
BCBS
—
01
—
500002461
RR MEDICARE
—
01
—
HP25440
HEALTH PARTNERS
—
Enumeration date
10/25/2005
Last updated
03/16/2023
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