Provider Demographics
NPI:1275800377
Name:THIEL, KYU-IN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KYU-IN
Middle Name:
Last Name:THIEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2046
Mailing Address - Country:US
Mailing Address - Phone:402-393-8451
Mailing Address - Fax:402-393-0466
Practice Address - Street 1:9001 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2046
Practice Address - Country:US
Practice Address - Phone:402-393-8451
Practice Address - Fax:402-393-0466
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist