Individual
KRISTAL PORTIER BRUPBACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
981 BURMA RD, THIBODAUX, LA 70301-6111
(985) 518-1045
Mailing address
981 BURMA RD, THIBODAUX, LA 70301-6111
(985) 518-1045
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20140159
LA
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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