Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Thaila Keodouangdy

Individual provider Family Nurse Practitioner · NPI 1104448919

Thaila Keodouangdy is a Nurse Practitioner in Citronelle, Alabama. Qualified in 2019, 7 years ago. Practices with Mobile County Board of Health, a 26-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
7
Licensed in
AL
In the registry since
2020

Practice location Address checks out

19250 N Mobile St
Citronelle, AL 36522-2122
Phone: (251) 866-9126
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 251 N Bayou St, Mobile, AL 36603-5827 — (251) 690-8158

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1-136625 (AL)

Record details

NPI number1104448919
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 14, 2020
Last updated in NPPESNovember 18, 2021
Certification dateNovember 18, 2021
Mailing addressPo Box 2867, Mobile, AL 36652-2867

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mobile County Board Of Health — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Citronelle