Individual
AMANDA THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
555 CEDAR ST, SAINT PAUL, MN 55101-2209
(651) 266-1241
(651) 266-1201
Mailing address
1583 ARCADE ST, SAINT PAUL, MN 55106-1051
(651) 266-1241
(651) 266-1201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2130295
MN
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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