Provider Demographics
NPI:1770997470
Name:THIELEN, MONICA (AGACNP BC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:THIELEN
Suffix:
Gender:F
Credentials:AGACNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 KESSLER ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2553
Mailing Address - Country:US
Mailing Address - Phone:913-632-9810
Mailing Address - Fax:913-632-9828
Practice Address - Street 1:7450 KESSLER ST STE 205
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2553
Practice Address - Country:US
Practice Address - Phone:913-632-9810
Practice Address - Fax:913-632-9828
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53 76283363LG0600X
KS53-76283363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology