Individual
JEAN M THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2121 ROCKWELL DR, MIDLAND, MI 48642-9316
(989) 633-5350
(989) 633-5340
Mailing address
2121 ROCKWELL DR, MIDLAND, MI 48642-9316
(989) 633-5350
(989) 633-5340
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
JT139745
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704139745
MI
Other
Enumeration date
09/23/2006
Last updated
09/25/2015
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