Individual
MICHELLE THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11701 BLUEGRASS PKWY STE 200, LOUISVILLE, KY 40299-2302
(502) 245-4168
(502) 244-0454
Mailing address
11701 BLUEGRASS PKWY STE 200, LOUISVILLE, KY 40299-2302
(502) 245-4168
(502) 244-0454
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006566
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50034884
PASSPORT
KY
05
—
7100153950
—
KY
Enumeration date
09/23/2010
Last updated
02/23/2024
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