Provider Demographics
NPI:1295014454
Name:THIELE, ASHA KATHRYN (RPH)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:KATHRYN
Last Name:THIELE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 CENTER CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-7047
Mailing Address - Country:US
Mailing Address - Phone:702-880-6500
Mailing Address - Fax:
Practice Address - Street 1:3210 N TENAYA WAY
Practice Address - Street 2:T-0826
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6239
Practice Address - Country:US
Practice Address - Phone:702-396-7840
Practice Address - Fax:702-396-7840
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist