Provider Demographics
NPI:1114724713
Name:VENTRESS, THOMAS (FNP-C)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:VENTRESS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2014
Mailing Address - Country:US
Mailing Address - Phone:337-482-1000
Mailing Address - Fax:
Practice Address - Street 1:104 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70504-3772
Practice Address - Country:US
Practice Address - Phone:337-482-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner