Kristi Thebeau, RN, BSN, CNOR

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

120532 Issued in MO

Practice address

2106 Hickory Summit CT
Wildwood, MO 63011-5402

Phone

(636) 405-2656

Fax

(636) 405-2656

NPI assigned

Dec 7, 2012

Last updated

Dec 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1790020378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 HICKORY SUMMIT CT",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630115402",
            "telephone_number": "636-405-2656",
            "fax_number": "636-405-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 HICKORY SUMMIT CT",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630115402",
            "telephone_number": "636-405-2656",
            "fax_number": "636-405-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBEAU",
        "first_name": "KRISTI",
        "credential": "RN, BSN, CNOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MO",
            "license": "120532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse First Assistant in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Registered Nurse First Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.