Organization
REFRESH HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY SAMPY THIBODEAUX FNP-C, PMHNP-BC (CEO)
(337) 520-2587
Entity
Organization
Contact information
Practice address
3419 NW EVANGELINE TRWY STE H-3, CARENCRO, LA 70520-6241
(337) 520-2587
(337) 520-2594
Mailing address
PO BOX 1003, CARENCRO, LA 70520-1003
(337) 520-2587
(337) 520-2590
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2427172
—
LA
Enumeration date
07/02/2020
Last updated
10/15/2023
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