Individual
AMANDA HUSSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 446-2936
Mailing address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 446-2936
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP09889
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295246585
BEHAVIORAL HEALTH
LA
Enumeration date
11/13/2018
Last updated
06/11/2019
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