Individual
MRS. ALLISON CLAIRE RICHARD VINING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4847
(337) 493-4843
(337) 449-4615
Mailing address
199 RAVENSAIDE DR, HOUMA, LA 70360-8356
(337) 298-3961
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2001.02
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1458279
—
LA
Enumeration date
10/04/2006
Last updated
07/17/2023
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