KELLY THIBAULT

NEWARK, NJ
NPI1730597360
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: NJ  26NJ0048730)
Additional Taxonomies363LP0200X Nurse Practitioner, Pediatrics
(Licence: NY  382415)
Enumeration Date2014-07-28
Last Update Date2025-08-26
Business Address
KELLY THIBAULT CRNP
201 LYONS AVE
NEWARK, NJ 07112-2027
Phone number: 973-926-7000
Mailing Address
KELLY THIBAULT CRNP
60 OAK PL
FAIR HAVEN, NJ 07704-3510
Phone number: 732-768-7857