Thiessen, Kellie R

Thiessen, Kellie R is an individual health care provider with primary practice located at 1201 E. Hwy 18 , Pine Ridge SD 57770. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Thiessen, Kellie R can be contacted via phone (605) 867-3003.

Contact Information

Primary practice address
1201 E. Hwy 18 Pine Ridge SD 57770
Phone: (605) 867-3003
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X

Profile Details

NPI number 1346213758
LBN Legal business name Thiessen, Kellie R
Credentials CNM,MS
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346213758 NPPES
South Dakota Other 036 CERTIFIED NURSE MIDWIFE

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