Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
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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