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1952760548
GINA THIBODEAUX
BRONX, NY
NPI
1952760548
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY f307578-1)
Enumeration Date
2016-02-11
Last Update Date
2016-02-11
Business Address
-- GINA THIBODEAUX AGNP
234 E 149TH ST
BRONX, NY 10451-5504
Phone number: 718-579-5820
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Mailing Address
-- GINA THIBODEAUX AGNP
1746 N ORANGE DR APT 615
LOS ANGELES, CA 90028-4362
Phone number: 504-858-3505
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