Healthcare Provider Details

I. General information

NPI: 1386616704
Provider Name (Legal Business Name): JENNIFER L THONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SIOUX VALLEY DR
LUVERNE MN
56156-4500
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 507-283-4476
  • Fax: 507-283-9086
Mailing address:
  • Phone: 605-328-8395
  • Fax: 605-328-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5682
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46532
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: