Individual
MS. NIKKI CLARY LEGLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 521-9100
Mailing address
4600 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6902
(337) 521-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200293
LA
Other
Enumeration date
10/19/2009
Last updated
06/20/2014
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