Thibault, Travis Lane
Thibault, Travis Lane is an sole proprietor health care provider with primary practice located at 8438 Timber Ridge Dr , De Soto KS 66018-7122. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Thibault, Travis Lane can be contacted via phone (913) 260-9250.Contact Information
Primary practice address
8438 Timber Ridge Dr
De Soto KS 66018-7122
Phone: (913) 260-9250
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2018001755 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 78038 | Kansas |
Profile Details
| NPI number | 1861990566 |
|---|---|
| LBN Legal business name | Thibault, Travis Lane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 28th, 2018 |
| Last updated | Jul 27th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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