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Contact Information

NICOLE O BOURGEOIS, PA-C
525 SAINT MARY ST
THIBODAUX, LA70301
 Phone: 985-446-6284
 Fax: 985-447-1754
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for NICOLE O BOURGEOIS · (Female)

NPI # 1982796991
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/28/2006
Last updated 07/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • LA License # TP507
  • LA Other P00395268 RAILROAD MEDICARE
Hospital affiliation(s)
  • TERREBONNE GENERAL MEDICAL CENTER - (Acute Care)
    8166 MAIN STREET
    HOUMA, LA 70360
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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