Provider Demographics
NPI:1629351804
Name:THIBODEAUX, JANELLE AUSTROM (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:AUSTROM
Last Name:THIBODEAUX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 E MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6766
Mailing Address - Country:US
Mailing Address - Phone:337-856-8881
Mailing Address - Fax:985-876-6122
Practice Address - Street 1:2910 E MILTON AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-6766
Practice Address - Country:US
Practice Address - Phone:337-856-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist