Individual
BROOKE RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
726 N ACADIA RD STE 2100, THIBODAUX, LA 70301-5078
(985) 447-2645
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 447-2645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200843
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03809331
—
MS
05
—
2406116
—
LA
Enumeration date
09/17/2015
Last updated
03/02/2026
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