Individual
MS. MARY TRICHE MORON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1002 12TH ST, LAFAYETTE, LA 70501-6224
(337) 534-0107
(337) 534-0184
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 367-3992
(337) 367-3994
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP03778
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1140082
—
LA
Enumeration date
04/19/2007
Last updated
10/22/2019
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