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Individual

JOEY DEWAYNE MCMICKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN117301
LA

Other

Enumeration date
03/06/2023
Last updated
03/06/2023
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