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AMANDA CHILDERS THIBODEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1053 DEER PARK DR, MADISONVILLE, LA 70447-3254
(601) 807-6374
Mailing address
1053 DEER PARK DR, MADISONVILLE, LA 70447-3254

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
245450
LA
207QA0505X
Adult Medicine Physician
908144
MS
363LF0000X
Family Nurse Practitioner
Primary
245450
LA
363LF0000X
Family Nurse Practitioner
908144
MS

Other

Enumeration date
02/05/2026
Last updated
03/09/2026
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