Healthcare Provider Details

I. General information

NPI: 1467313254
Provider Name (Legal Business Name): BRAIN INJURY NURSES OF ACADIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 KALISTE SALOOM RD STE 105
LAFAYETTE LA
70508-4231
US

IV. Provider business mailing address

825 KALISTE SALOOM RD STE 105
LAFAYETTE LA
70508-4231
US

V. Phone/Fax

Practice location:
  • Phone: 337-361-0074
  • Fax: 877-437-2906
Mailing address:
  • Phone: 337-361-0074
  • Fax: 877-437-2906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY GUILLOT THIBEAUX
Title or Position: OWNER
Credential: RN
Phone: 337-361-0074