Individual
CORY D THERIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
213 E ETIENNE RD, MAURICE, LA 70555-4375
(373) 740-9663
Mailing address
PO BOX 80055, LAFAYETTE, LA 70598-0055
(337) 344-4977
(337) 408-1341
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP04897
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1372986
—
LA
Enumeration date
07/26/2006
Last updated
06/25/2025
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