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Individual
BRENT K THIBODEAUX
Active
Individual
BRENT K THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP04823
LA
363LP2300X
Primary Care Nurse Practitioner
RN098583
LA
Other
Enumeration date
08/30/2006
Last updated
06/30/2011
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