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1346213758
KELLIE R THIESSEN
PINE RIDGE, SD
NPI
1346213758
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367A00000X Advanced Practice Midwife
Enumeration Date
2006-02-08
Last Update Date
2007-07-08
Business Address
Mrs. KELLIE R THIESSEN CNM,MS
1201 E. HWY 18
PINE RIDGE, SD 57770
Phone number: 605-867-3003
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Mailing Address
Mrs. KELLIE R THIESSEN CNM,MS
PO BOX 3055
PINE RIDGE, SD 57770-3055
Phone number: 605-867-2052
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