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Individual

SANDRA C THORNHILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
180 N 5TH ST, PONCHATOULA, LA 70454-2532
(985) 370-7768
Mailing address
180 N 5TH ST, PONCHATOULA, LA 70454-2532
(985) 370-7768

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN051026
LA

Other

Enumeration date
05/01/2006
Last updated
09/11/2007
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