Individual
DWAYNE ANDRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301
(985) 493-4740
(985) 449-2535
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 493-4740
(985) 446-5033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
76615-3364
LA
363LA2100X
Acute Care Nurse Practitioner
Primary
AP03364
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1569364
—
LA
Enumeration date
08/19/2006
Last updated
09/13/2018
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