Individual
BETHANIE TAYLOR THIBODAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1124 7TH ST, MORGAN CITY, LA 70380
(985) 384-2371
(985) 384-2645
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 828-5411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP08945/RN140939
LA
363LP2300X
Primary Care Nurse Practitioner
Primary
AP08945
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2434071
—
LA
01
—
693690
MEDICARE
LA
Enumeration date
10/27/2016
Last updated
06/20/2022
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