Individual
KIRSTEN ANN THIBODEAU NUTTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Contact information
Practice address
1001 MAIN ST FL 4, BUFFALO, NY 14203-1009
(716) 323-0110
(716) 323-0296
Mailing address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0225
(716) 323-0293
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382142
NY
363LP0222X
Critical Care Pediatric Nurse Practitioner
382142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03351782
—
NY
Enumeration date
07/27/2010
Last updated
03/25/2025
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