Individual
MS. NICOLE ORGERON BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
525 SAINT MARY ST, THIBODAUX, LA 70301
(985) 446-6284
(985) 447-1754
Mailing address
525 SAINT MARY ST, THIBODAUX, LA 70301-2627
(985) 446-6284
(985) 447-1754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TP507
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00395268
RAILROAD MEDICARE
LA
Enumeration date
09/28/2006
Last updated
07/05/2018
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