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NPI Code Detail

MEDICARE: EMILY KATHERINE THERIOT

MEDICARE: EMILY KATHERINE THERIOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN161569LA
2367500000XCertified Registered Nurse Anesthetist3-001562AL

General Provider Information

NPI Number : 1639858772
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY KATHERINE THERIOT
Provider Business Mailing Address
First Line : 5220 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3542
Country : US
Telephone Number : 228-380-0024
Fax Number :
Provider Business Practice Location Address
First Line : 5220 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3542
Country : US
Telephone Number : 228-380-0024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2023
Last Update Date : 12/20/2023

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Directions to “ EMILY KATHERINE THERIOT ” Practice Location

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