Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Critical Care
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
602 N ACADIA RD, THIBODAUX REGIONAL CRITICAL CARE, THIBODAUX, LA 70301-4823
(985) 447-5500
(985) 446-5033
Mailing address
602 N ACADIA RD, CONTRACT MANAGEMENT DEPT., THIBODAUX, LA 70301-4823
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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