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1295259901
LAINE K THIES
PEORIA, IL
NPI
1295259901
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209016231)
Enumeration Date
2017-08-03
Last Update Date
2022-07-21
Business Address
LAINE K THIES APN, CNP
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-655-2431
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Mailing Address
LAINE K THIES APN, CNP
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-655-2431
Copy
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