Individual
KATHY A THIESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1325 TRIPLETT ST, OWENSBORO, KY 42303-3163
(270) 688-4325
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
3009936
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100375350
—
KY
Enumeration date
11/11/2015
Last updated
12/15/2017
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