Individual
KENDRA A THIEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2222 SOUTH 16TH STREET, SUITE 240, LINCOLN, NE 68502-3764
(402) 323-7260
(402) 323-7266
Mailing address
2222 SOUTH 16TH STREET, SUITE 240, LINCOLN, NE 68502-3764
(402) 323-7260
(402) 323-7266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1354
NE
363A00000X
Physician Assistant
15-01367
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200593630A
—
KS
05
—
200593630B
—
KS
01
—
255216
MIDLANDS CHOICE
NE
01
—
39367
BCBS NE
NE
01
—
P00634904
RRM
—
Enumeration date
12/28/2007
Last updated
01/22/2025
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