Individual
MS. BETH A. THIELKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
410 W 10TH ST, HS1001, INDIANAPOLIS, IN 46202-3010
(317) 274-8812
(317) 274-0133
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28078636
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71002369
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201116970
—
IN
Enumeration date
06/25/2008
Last updated
11/19/2020
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