Individual
MEGAN THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, MSN
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
237514
WI
363L00000X
Nurse Practitioner
16108
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
101.0137205
VT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
16108
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100297896
—
WI
05
—
100298062
—
WI
Enumeration date
05/23/2024
Last updated
05/04/2026
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