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Individual
AMANDA H THIBERT
Active
Individual
AMANDA H THIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
177950
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
177950
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0357685
—
MA
01
—
39176
HARVARD PILGRIM
MA
01
—
NP9991
BLUE CROSS
MA
Enumeration date
03/08/2006
Last updated
03/08/2021
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