Individual provider · Type 1 NPI
Travis Lane Thibault
Family Nurse Practitioner · De Soto, KS
NPI number
1861990566
Active
Practice location
8438 Timber Ridge Dr
De Soto, KS 66018-7122
Mailing address
Kansas Emergency Physicians Llc, 9100 W 74th St
Shawnee Mission, KS 66204
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2018001755 (MO) |
| Family Nurse Practitioner Primary | 363LF0000X | 78038 (KS) |
Family Nurse Practitioner: Definition to come...
Other family nurse practitioner providers in De Soto
About NPI 1861990566
Travis Lane Thibault's National Provider Identifier is 1861990566, issued on Jan 28, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in De Soto, KS. The record was last updated on Jul 27, 2021.