Most Relevant Information
Provider Data
NPI Number: | 1003394891 |
Provider Name: | STEFANIE HUMMEL THERIOT PA-C |
Entity Type: | Individual |
Taxonomy Code: | 363AS0400X |
Specialty: | Physician Assistant |
License Number: | PA.308907 |
Most Important Dates
Enumeration Date: | 08/02/2018 |
Last Updated: | 08/24/2021 |
Provider Practice Location
105 PATRIOT ST STE 101
LAFAYETTE
LA
705086831
Practice Location Phone/Fax
Phone: | 3379812125 |
Fax: | 3379812174 |
Provider Mailing Location
200 CORPORATE BLVD
LAFAYETTE
LA
705083870
Provider Mailing Phone/Fax
Phone: | 8008939698 |
Fax: |