Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101235519 | VA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 300711 | LA |
NPI | 1255330353 |
---|---|
Provider Name | Threvia West |
First Address | Lafayette, LA 70503-5530 |
Second Address | Lafayette, LA 70508-6908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010196558 | (05) | VA |
10001823 | SENTARA (01) | VI |
10196558 | VIRGINIA PREMIER (01) | VA |
1028259 | CIGNA (01) | VA |
1153268 | AETNA HMO (01) | VA |
1427548 | MAMSI (01) | VA |
185232 | ANTHEM (01) | VA |
2409395 | (05) | LA |
325437 | SOUTHERN HEALTH (01) | VA |
4503577 | AETNA PPO (01) | VA |
540793767 | PHCS (01) | VA |
540793767 | VHN (01) | VA |
540793767014 | TRICARE (01) | VA |
5657179 | FIRST HEALTH (01) | VA |
E96025 | (02) | DC |