Provider Demographics
NPI:1144792409
Name:PAULSON-THIBODEAU, MALINDA (RNC)
Entity Type:Individual
Prefix:
First Name:MALINDA
Middle Name:
Last Name:PAULSON-THIBODEAU
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 STONE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5227
Mailing Address - Country:US
Mailing Address - Phone:207-873-2136
Mailing Address - Fax:207-660-4529
Practice Address - Street 1:66 STONE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5227
Practice Address - Country:US
Practice Address - Phone:207-873-2136
Practice Address - Fax:207-660-4529
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN49839163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health