Individual
JUDY ANNE THIBAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 MUNSEL CREEK LOOP, FLORENCE, OR 97439-9235
(541) 999-7109
Mailing address
203 MUNSEL CREEK LOOP, FLORENCE, OR 97439-9235
(541) 999-7109
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200440287RN
OR
Other
Enumeration date
06/16/2019
Last updated
06/19/2019
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