Individual
MICHELLE WAGUESPACK TEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4847
(800) 893-9698
Mailing address
18439 LAKEFIELD AVENUE, BATON ROUGE, LA 70817-3870
(985) 665-4270
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/08/2012
Last updated
09/06/2017
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