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General NPI Number Information
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NPI Number | 1942173802
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Entity Type | Individual
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Provider Name | SCOTT THIEMANN
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Gender | Male
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 130 S KNOWLES AVE
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City | NEW RICHMOND
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State | WI
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Zip | 54017-1727
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Country | US
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Telephone | 715-246-3018
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Fax |
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Provider Business Mailing Address
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Address Line | 11080 ARCOLA TRL N
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City | STILLWATER
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State | MN
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Zip | 55082-8312
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1113972-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3255
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 17552-33
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2330367
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License Number State | MN
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