Provider Demographics
NPI:1346645447
Name:THIES, JULIE CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:CHRISTINE
Last Name:THIES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-0980
Mailing Address - Country:US
Mailing Address - Phone:308-324-5651
Mailing Address - Fax:308-324-8359
Practice Address - Street 1:1201 N ERIE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1560
Practice Address - Country:US
Practice Address - Phone:308-324-5651
Practice Address - Fax:308-324-8359
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76378-091363LW0102X
NE112356363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health