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Individual

MRS. MOLLY ROE THIBODEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
1 MERCADO ST, SUITE 145 MERCY MEDICAL PLAZA, DURANGO, CO 81301-7306
(970) 247-5543
Mailing address
135 VALLEY CT, DURANGO, CO 81301-3744
(970) 749-5901

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
192552
CO
363LF0000X
Family Nurse Practitioner
Primary
NP 10151
CO

Other

Enumeration date
10/16/2009
Last updated
10/16/2009
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