Individual
VICKI CARONNA THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4228 HOUMA BLVD, SUITE 410, METAIRLE, LA 70006
(504) 883-3770
(504) 883-3711
Mailing address
4228 HOUMA BLVD, STE 410, METAIRIE, LA 70006-3021
(504) 883-3770
(504) 883-3711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN0403173125
LA
363LF0000X
Family Nurse Practitioner
Primary
AP03125
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1550680
—
LA
Enumeration date
05/17/2006
Last updated
01/12/2017
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