Provider Demographics
NPI:1861288896
Name:THIEP, PETER MANGUEL
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MANGUEL
Last Name:THIEP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-2456
Mailing Address - Country:US
Mailing Address - Phone:402-429-8965
Mailing Address - Fax:
Practice Address - Street 1:2610 W M CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-1006
Practice Address - Country:US
Practice Address - Phone:402-325-8555
Practice Address - Fax:402-325-8575
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist