Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 6853 | LA |
Y | 213EG0000X | General Practice | 6853 | LA |
NPI | 1003392234 |
---|---|
Provider Name | Dr. Aimee Dupree Ledet |
First Address | Thibodaux, LA 70301-3767 |
Second Address | Thibodaux, LA 70301-8096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2018 |
Last Update Date | 11/07/2018 |