Individual
CARLY THINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
17489 DODD BLVD, LAKEVILLE, MN 55044-6506
(952) 428-1020
Mailing address
17489 DODD BLVD, LAKEVILLE, MN 55044-6506
(952) 429-1020
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3091
MN
363LF0000X
Family Nurse Practitioner
Primary
3091
MN
Other
Enumeration date
08/07/2013
Last updated
02/23/2026
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