Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ashley Marie Thibodeau

Individual provider Nurse Practitioner · NPI 1396275582

Ashley Marie Thibodeau is a Nurse Practitioner in Detroit, Michigan. Graduated from Medical University of South Carolina College of Medicine in 2017, 9 years ago. Practices with University Pediatricians, a 128-clinician group and accepts Medicare assignment. Licensed in Michigan and Washington.

Years since qualifying
9
Trained at
Medical University of South Carolina College of Medicine
Licensed in
MI, WA
In the registry since
2017
Specialties on file
4
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Practice location Address checks out

3950 Beaubien St
Detroit, MI 48201-2166
Phone: (313) 832-9620
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704293510 (MI)
Pediatric Registered Nurse Taxonomy 163WP0200X · Licence 4704293510 (MI)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence 4704293510 (MI)
Pediatric Nurse Practitioner Taxonomy 363LP0200X · Licence AP60810818 (WA)

Record details

NPI number1396275582
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 19, 2017
Last updated in NPPESSeptember 11, 2025
Certification dateSeptember 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice University Pediatricians — 128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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