Provider Demographics
NPI:1346601911
Name:THIBEDEAU, KELLI N (PA)
Entity Type:Individual
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First Name:KELLI
Middle Name:N
Last Name:THIBEDEAU
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Gender:F
Credentials:PA
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Mailing Address - Street 1:51 PERFORMANCE DRIVE
Mailing Address - Street 2:BRIGHAM SURGICAL ASSOCIATES, SUITE 300
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189
Mailing Address - Country:US
Mailing Address - Phone:781-624-4943
Mailing Address - Fax:
Practice Address - Street 1:851 MAIN ST
Practice Address - Street 2:SUITE 11, BRIGHAM AND WOMEN'S NEUROSURGERY
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1612
Practice Address - Country:US
Practice Address - Phone:781-331-4923
Practice Address - Fax:781-340-0231
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2023-07-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant