Individual
MADISON THERIOT LESTAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1311 HORRIDGE ST, VINTON, LA 70668-4531
(337) 324-8060
Mailing address
212 ORCHARD DR, LAKE CHARLES, LA 70605-4444
(337) 965-6984
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
206785
LA
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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