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Individual

MS. KELLY LYNN THELEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3540 VILLAGE DR, SUITE 100, LINCOLN, NE 68516-4706
(402) 420-7113
(402) 328-8314
Mailing address
5930 S 58TH ST, SUITE A, LINCOLN, NE 68516-6402
(402) 483-0431
(402) 483-9905

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110335
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025777400
NE
01
37662
BCBS
NE
01
47381
BCBS
NE
Enumeration date
09/12/2006
Last updated
03/09/2015
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