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Individual

LISA RENEE THIELKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNP, PMHNP-BC

Contact information

Practice address
1708 1ST ST S, WILLMAR, MN 56201-4228
(218) 999-7750
Mailing address
28 NW 4TH ST STE A, GRAND RAPIDS, MN 55744-2714
(218) 999-7750

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10088
MN

Other

Enumeration date
04/18/2023
Last updated
04/20/2023
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