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Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Hospitalists
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 493-4710
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363LN0000X
Neonatal Nurse Practitioner
—
NULL
363LN0000X
Neonatal Nurse Practitioner
—
—
363LN0005X
Critical Care Neonatal Nurse Practitioner
—
NULL
363LN0005X
Critical Care Neonatal Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
10/14/2016
Last updated
09/05/2023
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