Individual
SHELLEY THIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8601
(269) 985-4549
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8601
(269) 985-4549
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704185694
MI
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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