Individual
LAUREN MARCELLO MICKENHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 709, BATON ROUGE, LA 70808-4300
(225) 765-7735
(225) 765-1023
Mailing address
7777 HENNESSY BLVD, SUITE 709, BATON ROUGE, LA 70808-4300
(225) 765-7735
(225) 765-1023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN117293
LA
363LF0000X
Family Nurse Practitioner
Primary
AP06748
LA
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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