Female

Mrs. Lynn R. Thibodeau PA

Physician Assistant in Fleming Island, FL(View on Map)

Full Name

Mrs. Lynn R Thibodeau PA

NPI Number

1811992696

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/17/2005

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA9107879

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 102222
4689 US HIGHWAY 17 STE 2

City

Atlanta
Fleming Island

State

GA
FL

Postal Code

30368-2222
32003-4831

Country

US
US

Telephone Number

(239) 274-8200
(904) 269-6526

Identifiers

Identifier

015211100

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/10/2024

Provider Address

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