Provider Demographics
NPI:1992102016
Name:THIEL, ANNE (ND)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:THIEL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 S 3RD ST
Mailing Address - Street 2:FL 2
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46526-3709
Mailing Address - Country:US
Mailing Address - Phone:574-535-0880
Mailing Address - Fax:574-535-0882
Practice Address - Street 1:313 S 3RD ST
Practice Address - Street 2:FL 2
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-3709
Practice Address - Country:US
Practice Address - Phone:574-535-0880
Practice Address - Fax:574-535-0882
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-04
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1935175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath