# JOSEPH C THERIAULT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063410843
- **Gender:** Man
- **Credential:** CNM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | 04290 | OH | — |
| 367A00000X | Advanced Practice Midwife | NM-04290 | OH | Yes |

## Other

- **Enumeration date:** 07/14/2005
- **Last updated:** 02/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000031422 | ANTHEM | OH |
| 01 | — | 05225 | PARAMOUNT | OH |
| 05 | — | 2065045 | — | OH |
| 01 | — | 344428256 | BEECHSTREET | OH |
| 01 | — | 344428256090 | CARESOURCE | OH |
| 05 | — | 3471545 | — | MI |