| Doctor Name: | MRS. SUSAN LEA THIEVON |
| NPI Number: | 1396847075 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. ARNP |
| License Number: | 0494952303 |
| Business Practice Address: | 240 S Main St Medical Arts Building Ste A Wolfeboro, NH - 038944411 |
| Business Phone Number: | 6035697574 |
| Business Fax Number: | 6035697582 |
| Mailing Address: | P O Box 912, WOLFEBORO |
| State: | NH |
| Postal Code: | 038940912 |
| Phone Number: | 6035697574 |
| Fax Number: | 6035697582 |
| NPI Enumeration Date: | 09/02/2006 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 0494952303 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |