| NPI | 1447854294 |
|---|---|
| Doing Business As | THIBODAUX REGIONAL PEDIATRIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | KIM LEGENDRE BOUDREAUX Contract Manager 985-493-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2025-03-06 |