Individual
MRS. VICKI LYNN THUESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP WHNP
Contact information
Practice address
9801 VALLEY GROVE DR, LOLO, MT 59847-8617
(406) 273-4633
(406) 273-4707
Mailing address
9801 VALLEY GROVE DR, LOLO, MT 59847-8617
(406) 273-4633
(406) 273-4707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN9284
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374740
BCBS PROVIDER NUMBER
MT
05
—
4305535
—
MT
Enumeration date
04/26/2007
Last updated
09/01/2020
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