MS. SANDRA LEE BROMMELAND GONZALEZ


Address: 1101 Audubon Ave, Thibodaux, LA 70301-4957
Phone: 9858573615

MS. SANDRA LEE BROMMELAND GONZALEZ (NPI# 1053428342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053428342
Entity Type Individual
Full Name MS. SANDRA LEE BROMMELAND GONZALEZ
Credential APRN-BC
Practice Address 1101 Audubon Ave
Thibodaux
LA 70301-4957
Mailing Address 929 Bayou Dularge Rd
Houma
LA 70363-7614
Practice Telephone 9858573615
Practice Fax Number 9412957336
Mailing Telephone 9858723550
Mailing Fax Number 9412957336
Enumeration Date 2006-08-24
Last Update Date 2015-01-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
AP 5139 LA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
LA 1022004 05

Office Location

Street Address 1101 AUDUBON AVE
City THIBODAUX
State LA
Zip Code 70301-4957

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275535148 Thibodaux Laser and Surgery Center, LLC Nurse Anesthetist, Certified Registered 1101 Audubon Ave, Suite S4, Thibodaux, LA 70301-4957 2005-08-11
1316436199 Richard L Arceneaux, Md LLC Ophthalmology 1101 Audubon Ave, Suite N-5, Thibodaux, LA 70301 2018-05-07
1184913451 Psychiatric Solutions LLC Clinic/Center 1101 Audubon Ave, Thibodaux, LA 70301-4957 2011-04-07
1396063996 Richard L. Arceneaux Ophthalmology 1101 Audubon Ave, Ste N-5, Thibodaux, LA 70301-4957 2010-05-07
1710219688 Quentin D. Falgoust, Md, Amc Eyewear Supplier (Equipment, not the service) 1101 Audubon Ave, Ste N5, Thibodaux, LA 70301-4957 2010-02-03
1073609772 Amy M. Johnson Registered Nurse 1101 Audubon Ave, Ste S-4, Thibodaux, LA 70301-4957 2006-10-04
1871603159 Summer A. Bell Licensed Practical Nurse 1101 Audubon Ave, Ste S-4, Thibodaux, LA 70301-4957 2006-08-30
1174533798 James Joseph Leonard Urology 1101 Audubon Ave, Sn3, Thibodaux, LA 70301-4957 2006-08-08
1083634133 Becky M. Logan Specialist/Technologist, Other 1101 Audubon Ave, Ste S-4, Thibodaux, LA 70301-4957 2006-07-20
1205856325 David W. Lindner Registered Nurse 1101 Audubon Ave, Ste S-4, Thibodaux, LA 70301-4957 2006-07-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225539620 Micah Aaron Callais Nurse Practitioner 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 2018-02-22
1982112348 Katie Leblanc Massage Therapist 1115 St. Mary Street, Thibodaux, LA 70301 2018-01-18
1154837391 Texas Digestive Disease Consultants, Pllc Internal Medicine 764 North Acadia Road, Suite A, Thibodaux, LA 70301 2017-12-26
1235648239 Speech and Feeding Therapy, LLC Speech-Language Pathologist 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 2017-09-22
1285150466 Tara Payne Counselor 303 Hickory Street, Thibodaux, LA 70301 2017-08-18
1427583475 Tyler Pettigrew Counselor 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 2017-04-27
1750825758 Jessica Barquet Counselor 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 2016-12-09
1013468230 Shenee Haas Gros Counselor 504 Cherry St., Thibodaux, LA 70301 2016-10-24
1982155388 Southern Ent Associates Inc Audiologist 604 North Acadia Road Suite 101, Thibodaux, LA 70301 2016-10-20
1215483888 Lesheeca Norman, Lpc Counselor 306 Victoria Court, Thibodaux, LA 70301 2016-09-01
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346855517 Ryan Michael Kelley Nurse Practitioner 126 Rue Colette, Thibodaux, LA 70301-5628 2020-09-14
1568931129 Amanda Hussey Nurse Practitioner 303 Hickory St, Thibodaux, LA 70301-2011 2018-11-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1972113124 Rebirth Mental Health Services LLC Nurse Practitioner 2116 Gause Blvd W Ste E, Slidell, LA 70460-4120 2020-08-03
1427668748 Julie Susann Dyrek Nurse Practitioner 1 Lakeshore Dr Ste 1830, Lake Charles, LA 70629-0114 2020-08-01
1376169979 Nancy Ariwodo Nurse Practitioner 225 Rue La France, Lafayette, LA 70508-1565 2020-06-19
1578183208 Donald Glyn Gardner II Nurse Practitioner 324 Blue Fox Cir, Haughton, LA 71037-7707 2020-04-22
1629604129 Raelyn Marie Plauche Nurse Practitioner 1951 Florida Ave Sw Ste D&e, Denham Springs, LA 70726-4947 2020-03-16
1962035964 Tyler Trenton Wansley Nurse Practitioner 23515 Us-190, Mandeville, LA 70448 2020-02-18
1114558715 Danielle J Threatts Aprn LLC Nurse Practitioner 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 2020-02-01
1992359848 Harold G Frizzell Psychiatric Services LLC Nurse Practitioner 300 Thompson Loop, Lafayette, LA 70506-2820 2019-07-29
1598227779 Candyce Brown Nurse Practitioner 333 Dr Michael Debakey Dr Ste 220, Lake Charles, LA 70601-5888 2019-04-04
1659835346 Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. Nurse Practitioner 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 2019-01-26
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Competitor

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City THIBODAUX
Zip Code 70301

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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