# DR. JENNIFER THIBAULT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1861258766
- **Gender:** F
- **Credential:** DNP, APRN, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 1386721081 | KS | — |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 5383530081 | KS | Yes |

## Other

- **Enumeration date:** 02/27/2024
- **Last updated:** 10/20/2025