Individual
KATE G THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Contact information
Practice address
242 BRUNSWICK ST, OLD TOWN, ME 04468-1613
(207) 827-6128
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP211240
ME
Other
Enumeration date
08/05/2021
Last updated
10/07/2021
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