Individual
MRS. SUSAN NICKERSON CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 424-6002
Mailing address
340 CORINNE CIR, SHREVEPORT, LA 71106-6004
(318) 865-0994
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20297
TX
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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