BRANDON WAYNE VIDRINE (NPI# 1053540187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053540187 |
| Entity Type | Individual |
| Full Name | BRANDON WAYNE VIDRINE |
| Credential | NP |
| Practice Address |
2810 Ambassador Caffery Pkwy Lafayette LA 70506-5906 |
| Mailing Address |
200 Corporate Blvd Suite 201 Lafayette LA 70508-3870 |
| Practice Telephone | 8008939698 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2020-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN109960 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP123619 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2810 AMBASSADOR CAFFERY PKWY |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245236413 | Peter N Agomuo | Radiology | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2005-06-22 |
| 1124636683 | Lauren Butcher | Nurse Practitioner | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2020-07-21 |
| 1750999157 | Beauvais Health, LLC | Rehabilitation Unit | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2020-07-21 |
| 1154845808 | Collins T Kgoadi | Emergency Medicine | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2017-08-02 |
| 1992140701 | Degeyter and Rossitter Medical Research and Development LLC | Internal Medicine | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2013-05-07 |
| 1174898845 | Rmca Professionals Mgmt, LLC | Internal Medicine | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2012-03-14 |
| 1376869008 | Tracy Nicole Thibodeaux | Speech-Language Pathologist | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2010-04-20 |
| 1831422187 | Tommie Jude Hebert | Nurse Practitioner | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2009-09-17 |
| 1467686220 | Audrey Hopkins Davis | Occupational Therapist | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2009-05-08 |
| 1740414614 | Kelly Ann Malloy | Occupational Therapy Assistant | 2810 Ambassador Caffery Pkwy, Lafayette, LA 70506-5906 | 2009-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
| Find all providers in zip 70506 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915233 | Christi Danielle Carmouche | Nurse Practitioner | 119 Crooked Stick Ln, Lafayette, LA 70506-7539 | 2020-09-03 |
| 1881204808 | Shavondali Harris Cawthorne | Nurse Practitioner | 945 Bellevue Plantation Rd, Lafayette, LA 70503-6122 | 2020-08-04 |
| 1386253870 | Millcreek Medical LLC | Nurse Practitioner | 105 Moss Brook Dr, Lafayette, LA 70508-8039 | 2020-07-30 |
| 1174145759 | Synita Wooten | Nurse Practitioner | 200 Highway 52 Byp E, Lafayette, TN 37083-1353 | 2020-05-18 |
| 1316567548 | Michelle Cataldo | Nurse Practitioner | 605 Viridian Dr Apt 148, Lafayette, CO 80026-7045 | 2020-04-17 |
| 1255974515 | Dr. Terrell S Manuel, LLC | Nurse Practitioner | 336 Brightwood Dr, Lafayette, LA 70508-7358 | 2019-10-19 |
| 1477117562 | Kayley Jon Myers | Nurse Practitioner | 200 Beaullieu Dr Ste 6, Lafayette, LA 70508-7230 | 2019-04-24 |
| 1003371840 | Brandi Rene Boutte | Nurse Practitioner | 1101 Kaliste Saloom Rd Ste 304, Lafayette, LA 70508-5705 | 2019-02-06 |
| 1265912141 | Kathryn Lynn Armentor Boutte | Nurse Practitioner | 4212 W Congress St Ste 3300, Lafayette, LA 70506-6789 | 2018-08-20 |
| 1801380829 | Sarah Darouse | Nurse Practitioner | 155 Hospital Dr Ste 101, Lafayette, LA 70503-2852 | 2018-06-22 |
| Find all providers in LAFAYETTE | ||||
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| 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.