Theriot, Matthew Blaine

Theriot, Matthew Blaine is an sole proprietor health care provider with primary practice located at 2362 Larkspur Ln , Opelousas LA 70570-8674. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Theriot, Matthew Blaine can be contacted via phone (337) 594-0675.

Contact Information

Primary practice address
2362 Larkspur Ln Opelousas LA 70570-8674
Phone: (337) 594-0675
Fax: (337) 594-0850
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP04908 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP04908 Louisiana

Profile Details

NPI number 1346296027
LBN Legal business name Theriot, Matthew Blaine
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2006
Last updated Apr 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346296027 NPPES
Louisiana MEDICAID 1527408

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