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Individual

MRS. JENNIFER MARIE THIELLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
801 HARMONY ST STE 202, COUNCIL BLUFFS, IA 51503-3106
(712) 308-1563
Mailing address
11284 NORTHRIDGE DR, GRETNA, NE 68028-6905
(402) 332-5053

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
111382
NE

Other

Enumeration date
08/20/2012
Last updated
02/15/2013
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