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General NPI Number Information
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NPI Number | 1992092019
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Entity Type | Individual
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Provider Name | KYLIE YOUNG THIBODEAUX WHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/10/2011
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1270 ATTAKAPAS DR STE 402
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City | OPELOUSAS
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State | LA
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Zip | 70570-6557
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Country | US
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Telephone | 337-948-4030
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Fax | 888-720-0474
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Provider Business Mailing Address
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Address Line | 1270 ATTAKAPAS DR STE 402
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City | OPELOUSAS
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State | LA
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Zip | 70570-6557
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Country | US
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Telephone | 337-948-4030
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Fax | 888-720-0474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP06541
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License Number State | LA
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