# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Hospitalists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447701412
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 602 N ACADIA RD, THIBODAUX, LA 70301-4823
- **Practice address phone:** (985) 493-4710
- **Mailing address:** PO BOX 5478, THIBODAUX, LA 70302-5478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 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