Individual
ELIZABETH THIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-7100
(814) 272-6501
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN683533
PA
363L00000X
Nurse Practitioner
Primary
SP024313
PA
Other
Enumeration date
01/16/2017
Last updated
11/24/2021
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