Provider Demographics
NPI:1013589415
Name:THIBODEAUX, SHEILA ANN (RN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:THIBODEAUX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4157
Mailing Address - Country:US
Mailing Address - Phone:877-277-8873
Mailing Address - Fax:828-505-0366
Practice Address - Street 1:277 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4157
Practice Address - Country:US
Practice Address - Phone:877-277-8873
Practice Address - Fax:828-505-0366
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC212369163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse