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NICOLE D PROSPERIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
604 N ACADIA RD STE 500, THIBODAUX, LA 70301-4743
(985) 448-1216
(985) 446-8765
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 448-1216
(985) 446-8765

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD203822
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000965
LA
01
P01534049
RAILROAD MEDICARE
LA
Enumeration date
08/01/2007
Last updated
03/17/2026
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