Provider Demographics
NPI:1063828614
Name:THIELBAR, ERIN R (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:R
Last Name:THIELBAR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8373 UNITY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-4005
Mailing Address - Country:US
Mailing Address - Phone:218-748-7480
Mailing Address - Fax:218-748-7488
Practice Address - Street 1:8373 UNITY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-4005
Practice Address - Country:US
Practice Address - Phone:218-748-7480
Practice Address - Fax:218-748-7488
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN169642-6363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner