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Individual

MRS. TIFFANY SAMPY THIBODEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C, PMHNP-BC

Contact information

Practice address
3419 NW EVANGELINE TRWY STE H-3, CARENCRO, LA 70520-6241
(337) 520-2587
(337) 520-2594
Mailing address
3419 NW EVANGELINE TRWY STE H-3, CARENCRO, LA 70520-6241
(337) 520-2587
(337) 520-2594

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP08711
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP08711
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2427172
LA
Enumeration date
04/29/2016
Last updated
05/16/2025
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