Individual
GABRIELLE NICOLLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3402 MAGNOLIA CV, MONROE, LA 71203-2374
(318) 388-5830
Mailing address
6081 RAVINE RD, BASTROP, LA 71220-7839
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06880
LA
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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