Individual provider · Type 1 NPI

Ginger Nichole Thibault

Pediatric Nurse Practitioner · Round Rock, TX

NPI number 1679964019 Active

Practice location

425 University Blvd
Round Rock, TX 78665-1360

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice locations

  • 9040 Jackson Ave, Tacoma, WA 98431-4426 · (253) 968-2464

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200XAP61333001 (WA)
Pediatric Registered Nurse 163WP0200XR0077265 (OK)
Pediatric Nurse Practitioner 363LP0200XR0077265 (OK)
Pediatric Nurse Practitioner Primary 363LP0200X1232486 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1679964019

Ginger Nichole Thibault's National Provider Identifier is 1679964019, issued on Feb 6, 2015. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Round Rock, TX. The record was last updated on Sep 25, 2026.