Provider Demographics
NPI:1497237424
Name:THOENDEL, CARRIE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:THOENDEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 D ST
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-1753
Mailing Address - Country:US
Mailing Address - Phone:402-538-4805
Mailing Address - Fax:
Practice Address - Street 1:750 D ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632
Practice Address - Country:US
Practice Address - Phone:402-367-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE58263163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool