Theresa Bourg Vicknair, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lutcher, Louisiana. Her current practice location is
St James Parish Hosipital, Louisiane Ave, Lutcher, Louisiana. You can reach out to her office (for appointments etc.) via phone at
(225) 869-5512.
Theresa Bourg Vicknair is licensed to practice in Louisiana (license number AP01519) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1134100746.
Provider's Profile
Full Name | Theresa Bourg Vicknair |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | St James Parish Hosipital, Lutcher, Louisiana |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Theresa Bourg Vicknair attended and graduated from in
NPI Data:
- NPI Number: 1134100746
- Provider Enumeration Date: 11/10/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Theresa Bourg Vicknair such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134100746 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN059871 (Louisiana) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | AP01519 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theresa Bourg Vicknair is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Theresa Bourg Vicknair, CRNA 124 Jennifer Ln, La Place, LA 70068-5806 Ph: (985) 359-0599 | Theresa Bourg Vicknair, CRNA St James Parish Hosipital, Louisiane Ave, Lutcher, LA 70071 Ph: (225) 869-5512 |
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