Individual
RAECHEL ANNE THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20399 GOVERNMENT BLVD, LIVINGSTON, LA 70754
(225) 686-7017
Mailing address
20399 GOVERNMENT BLVD, LIVINGSTON, LA 70754
(225) 686-7017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
LA155294
LA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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