Individual provider · Type 1 NPI
Ashley Marie Thibodeau
Nurse Practitioner · Detroit, MI
Practice location
3950 Beaubien St
Detroit, MI 48201-2166
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 4704293510 (MI) |
| Pediatric Registered Nurse | 163WP0200X | 4704293510 (MI) |
| Pediatric Nurse Practitioner | 363LP0200X | 4704293510 (MI) |
| Pediatric Nurse Practitioner | 363LP0200X | AP60810818 (WA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1396275582
Ashley Marie Thibodeau's National Provider Identifier is 1396275582, issued on Jun 19, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Detroit, MI. The record was last updated on Sep 11, 2025.