Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TRAVIS LANE THIBAULT
Active Sole ProprietorTRAVIS LANE THIBAULT is a Family Nurse Practitioner healthcare provider located in DE SOTO, Kansas. NPI 1861990566 is currently active in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · DE SOTO, KS
Registration Details
- NPI Number
- 1861990566
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 28, 2018 (8.508504276947 yrs)
- Last Updated
- Jul 27, 2021
- Licenses
-
2018001755 (MO)78038 (KS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8438 TIMBER RIDGE DRDE SOTO, KS, 660187122Browse KS providers · Browse ZIP 66018
- Phone
- 9132609250
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
- Additional Specialty
- Family Nurse Practitioner
Other Family Nurse Practitioner Providers in DE SOTO, KS
| Name | Credential | NPI |
|---|---|---|
| WILLIAM DOLAN | APRN, FNP-BC | 1861026270 |
| NANA AMMA ASANTE | — | 1932705647 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.