Provider Demographics
NPI:1700533346
Name:THIEROFF, EMILY E (CNM)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:THIEROFF
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 E ELM ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2803
Mailing Address - Country:US
Mailing Address - Phone:419-998-8245
Mailing Address - Fax:419-998-8247
Practice Address - Street 1:1220 E ELM ST STE 101
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2803
Practice Address - Country:US
Practice Address - Phone:419-998-8245
Practice Address - Fax:419-998-8247
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.0019505367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife