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Organization

PEDIATRICS REIMAGINED LLC

Active
Other names
Your Local Pediatrics on Demand
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE THEARD DNP, CPNP-AC (MANAGING MEMBER)
(504) 343-4714
Entity
Organization

Contact information

Practice address
1901 HIGHWAY 190 STE 9, MANDEVILLE, LA 70448-3495
(985) 231-4060
(985) 353-4460
Mailing address
1901 HIGHWAY 190 STE 9, MANDEVILLE, LA 70448-3495
(985) 231-4060
(985) 353-4460

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2652290
LA
Enumeration date
10/16/2023
Last updated
10/31/2025
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