Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 35042512T | OH |
Y | 207VG0400X | Gynecologist | 35042512T | OH |
NPI | 1265549760 |
---|---|
Provider Name | Jennifer L Thie |
First Address | Carmel, IN 46032-3950 |
Second Address | Cincinnati, OH 45242-4400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0218740 | (05) | OH |
F13527 | (02) | OH |