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General NPI Number Information
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NPI Number | 1851180830
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Entity Type | Individual
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Provider Name | ELIZABETH NICOLE THELIN CNP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 401 12TH ST N
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City | WHEATON
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State | MN
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Zip | 56296-1070
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Country | US
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Telephone | 320-563-8226
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202250
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 12791
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R057942
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 2498305
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License Number State | MN
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