Thibodeau, Lynn R
Thibodeau, Lynn R is an individual health care provider with primary practice located at 4689 Us Highway 17 Ste 2 , Fleming Island FL 32003-4831. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Thibodeau, Lynn R can be contacted via phone (904) 269-6526.Contact Information
Primary practice address
4689 Us Highway 17 Ste 2
Fleming Island FL 32003-4831
Phone: (904) 269-6526
Fax: (904) 269-6527
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA9107879 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9107879 | Florida |
Profile Details
| NPI number | 1811992696 |
|---|---|
| LBN Legal business name | Thibodeau, Lynn R |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Jul 10th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811992696 | NPPES |
| Florida | MEDICAID | 015211100 |
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