Thaila Keodouangdy, | |
19250 N Mobile St, Citronelle, AL 36522-2122 | |
(251) 866-9126 | |
Not Available |
Full Name | Thaila Keodouangdy |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 6 Years |
Location | 19250 N Mobile St, Citronelle, Alabama |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104448919 | NPI | - | NPPES |
261555 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 1-136625 (Alabama) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mobile County Board Of Health | 9931208386 | 24 |
Entity Name | Mobile County Board Of Health |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063439065 PECOS PAC ID: 9931208386 Enrollment ID: O20180913000728 |
Mailing Address | Practice Location Address |
---|---|
Thaila Keodouangdy, Po Box 2867, Mobile, AL 36652-2867 Ph: (251) 690-8158 | Thaila Keodouangdy, 19250 N Mobile St, Citronelle, AL 36522-2122 Ph: (251) 866-9126 |
Mr. Charles Seth Davis, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-7454 Fax: 251-866-9121 | |
Mrs. Latanja Shanta Batain, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-7454 Fax: 251-544-2188 | |
Ms. Hillary Macall Whitfield, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 | |
Nancy Ursprung, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-7454 Fax: 251-866-9121 |