Provider Demographics
NPI:1043801012
Name:THIELKE, BEVERLY BATALLA (APRN)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:BATALLA
Last Name:THIELKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3459 SAINT ROSE PKWY STE 120-481
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4601
Mailing Address - Country:US
Mailing Address - Phone:702-781-4800
Mailing Address - Fax:702-664-6755
Practice Address - Street 1:1669 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3516
Practice Address - Country:US
Practice Address - Phone:702-781-4800
Practice Address - Fax:702-664-6755
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV837645363L00000X, 363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily