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Thaila Keodouangdy
Family Nurse Practitioner in Citronelle, Alabama
NPI 1104448919

Thaila Keodouangdy is a Family Nurse Practitioner based in Mobile, AL and is specialized in Family. Thaila Keodouangdy practices in Citronelle, AL. The NPI Number for Thaila Keodouangdy is 1104448919 and holds a License No. 1-136625 (Alabama).

The current practice location address for Thaila Keodouangdy is 19250 N Mobile St, Citronelle, AL and can be reached out via phone at 251-866-9126.

Location: 19250 N Mobile St, Citronelle, AL, 36652-2867
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104448919
Provider Name
Thaila Keodouangdy
Credential
Provider Entity Type
Individual
Gender
Female
Address
19250 N Mobile St, Citronelle, AL, 36652-2867
Phone Number
251-866-9126
Fax Number
Provider Enumeration Date
05/14/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
261555 05 AL
institution
Provider Business Practice Location Address Details
Address
19250 N Mobile St
City
Citronelle
State
Alabama
Zip
36522-2122
Phone Number
251-866-9126
Fax Number
person
Provider Business Mailing Address Details
Address
19250 N Mobile St
City
Citronelle
State
Alabama
Zip
36522-2122
Phone Number
251-866-9126
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
1-136625 (Alabama)
Definition
Definition to come...
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