Individual provider · Type 1 NPI

Shannon Thebado

Psychiatric/Mental Health Nurse Practitioner · Brockton, MA

NPI number 1821801135 Active

Practice location

231 Main St Fl 3
Brockton, MA 02301-4342

Mailing address

315 Canton St
Stoughton, MA 02072-2205

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XRN2330456 (MA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1821801135

Shannon Thebado's National Provider Identifier is 1821801135, issued on Jan 30, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Brockton, MA. The record was last updated on Jan 30, 2025.