Individual
MS. ANDREA K THELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5150 JOURNAL CENTER BLVD NE, ALBUQUERQUE, NM 87109
(505) 262-3233
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-3135
(505) 232-1627
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2010-0024
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31602843
—
NM
01
—
PA08598
LICENSE
TX
Enumeration date
04/12/2010
Last updated
03/16/2020
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